Stature Estimation Using Postmortem Computed Tomography Scan Images of Long Limbs

Special Article - Forensic and Legal Medicine

Austin J Forensic Sci Criminol. 2017; 4(1): 1059.

Stature Estimation Using Postmortem Computed Tomography Scan Images of Long Limbs

Soon LP¹*, Hasmi AH², See KL¹, Mohamad Noor MH³ and Feng SS²

¹Department of Forensic Science, Institute of Forensic Medicine Malaysia, Malaysia

²Department of Forensic Pathology, Institute of Forensic Medicine Malaysia, Malaysia

³Department of Forensic Radiology, Kuala Lumpur Hospital, Malaysia

*Corresponding author: Lai Poh Soon, Department of Forensic Science, Institute of Forensic Medicine Malaysia, Kuala Lumpur Hospital, Malaysia

Received: February 02, 2017; Accepted: March 03, 2017; Published: March 20, 2017


Introduction: Estimation of stature is an important tool in developing a biological profile for human identification especially using long bones. Thus far, stature estimation had been done mostly based on the American population. Both Thai Formula [6] and Malaysia Formula [4] were currently practice applied by Forensic Anthropologists in Malaysia. Amongst the Asian population, this study had shown that Thai Formula with direct bone measurement have higher accuracy and reliability compared to the Malaysia Formula.

Methodology: A new tool is developed in this study to Formulate stature estimation by measuring via Postmortem Multislice Computed Tomography (PMCT) images on the average bilateral length measurements of 3 long bones including humerus, femur and tibia. All the postmortem cases in year 2015 involved Asian Population with known stature were included. A total sample size of 333 were selected by convenience sampling based on the archived PMCT images available and those images with fractured bones or presenting out of the PMCT framework were excluded.

Results and Discussion: Statistical analyses showed that there was a significant difference of stature between sex but not significant between population and ancestry. Statistical Package for Social Sciences (SPSS) Regression analysis proved that lower limbs have higher correlation with the stature compared with upper limbs. This study has created more reliable Formula for Malaysia population compared to Non-Malaysia Asian population. For unknown dead bodies, forensic anthropologists were recommended to use both Femur and Tibia Length and the Formula under combined category to resemble the Asian population.

Keywords: Regression Formula; Stature estimation; Postmortem computed tomography; Long limbs


Anthropological approach is used for determination of biological profiles based on the features of the skeleton remains likewise the skull and pelvic bones for sex determination whilst the long bones for the status estimation. One of the major advantages of postmortem multislice computed tomography (PMCT) is the possibility of performing an anthropological study of the cadaver especially noninvolvement of international legal issue or criminal elements. For instance, disaster victim identification in local perspective. This avoids the necessity to prepare and deflesh bones, and the ethnic origin, stature, age and sex can be estimated using especially 3 dimensional (3D) viewers on the Digital Imaging and Communication in Medicine (DICOM) files of the PMCT images. Moreover, the anthropological preliminary reports can support the subsequent findings of primary identifiers such as Forensic Deoxyribo-Nucleic Acid (DNA), Forensic Odontology and Forensic Fingerprint. In this domain, PMCT opens a new field of research that is called virtual anthropology [1].

Several methods can be used to establish the stature of the body such as the direct measurement of the bones displayed externally or internally of the dead bodies; however this could only be estimated through the secondary identifier likewise with known biological profiles. With a continuous set of CT data, virtual sections at arbitrary angles through the volume can be calculated and the distance between two points, such as both ends of a bone, within such a plane can be measured. If the body can be laid outstretched on the examination table, its full length can be determined from the CT data in one single measurement. If this is not possible due to contractures, e.g. in burnt victims, the body stature can still be determined by adding the measured lengths of a number of skeleton segments. Finally, if the body is not complete, other anthropological methods can be applied. These are expressed as Formula which have the lengths of several of the long bones of the extremities as parameters [2].

Among all the stature predictors, the long bones of lower extremities are extensively used in stature estimation [3]. Studies have shown that femur is more reliable in estimating stature compared to skeletal elements such as metatarsal, metacarpal, calcaneum and fragmentary tibia [4]. Stature estimation may be specifically derived from each population. Specific regression for specific population is important to account for inherent population variations such as genetic and environmental factors. Furthermore, the regressions will also take into account the human internal factors such as sex and agerelated changes [4].

The application of CT was useful for the documentation of wholebody anatomical data on routine autopsy, virtual reconstruction of skeletal structure, objective measurements, and reassessment by repetitive analyses [3]. There were studies showing the usage of PMCT data of forensic autopsy cases of Japanese over 19 years in investigating the virtual CT morphometry of lower limb long bones, including the femur, tibia, fibula, and first metatarsus, to estimate the sex and stature (total n=259, 150 males and 109 females). Bone mass volumes, lengths, and total CT attenuation values of bilateral femurs, tibias, and fibulas were co-related with the stature. Correlations with the stature were similar for the lengths and mass volumes of the femur, tibia, and fibula (r=0.77-0.85) but were higher for the mass volume of the first metatarsus (r=0.77 for right and r=0.58 for left). In addition, the ratio of the bone volume to the length of each bone showed the most significant sex-related differences (males > females with accuracy of 75.8-98.1%). These findings illustrate the effectiveness of virtual CT morphometry of individual lower limb long bones, including volumetry, in estimating the sex and stature in identification [3].

Estimation of stature is an important step in developing a biological profile for human identification especially using femur bones that often found in the scene of death or crime scene by the police investigating officers and publics. It may provide a valuable indicator for unknown individual in a population. Thus, stature estimation had been mostly done using the regressions based on the American population; however these regressions may not be applicable to the Asian population [5].

Lists of existing Formula formerly used as references by the Forensic Anthropologists in Hospital Kuala Lumpur and Ministry of Health, Malaysia:

There were insufficient amount of studies for stature estimation in the Malaysia population but it is certainly warranted to produce regressions based on the Malaysia population. A study conducted in 2013 to analyze the relationship between stature and lower limb dimensions in the Malaysia population. The samples are 100 corpses that consist of 69 males and 31 females aged between 20 to 90 years old. The parameters measured were stature, thigh length, lower leg length, leg length, foot length, foot stature and foot breadth. Results showed that the mean values in males were significantly higher than those in females (p<0.05). There were significant correlations between lower limb dimensions and stature [4]. Another study was carried out on a sample of 200 skeletons from a northern Thai population (132 males and 68 females), ranging in age from 19 to 94 years. The maximum lengths of six long bones (humerus, radius, ulna, femur, tibia and fibula) were measured and the stature reconstruction Formula was generated using linear regression. The results showed that the three lower limb bones are the most accurate estimators of stature among the males [6].

The main focus of this study was to compute stature using the PMCT images of 3 long bones including humerus, femur and tibia by applying the existing Formula and subsequently compared to the actual stature. The accuracy and reliability of each Formula were compared. Occasionally, statistical analysis was conducted to formulate a new tool of stature estimation using the anthropometry data of humerus, femur and tibia length. Subsequent validation on the Formula has been conducted to confirm the effectiveness of the new tool of stature estimation.

General objectives

Compare and formulate the stature estimation by using PMCT Scan images of long bones including humerus, femur and tibia.

Specific objectives


All the postmortem cases aged 19-79 with known stature that were scanned using PMCT in 2015 included the total sample size of 333 by retrospective convenience sampling based on the archived PMCT images available in Forensic Medicine Department of Hospital Kuala Lumpur, Malaysia. This study was registered with National Medical Research Register (NMRR-16-354-29822) and has obtained clearance from local Medical Research and Ethics Committees (MREC).

Exclusion criteria’s were all the fractured bones or presenting out of the PMCT framework to eliminate the bone defects factor and dead bodies aged below 18 years also were excluded to avoid any age-dependent developmental factor. Throughout this retrospective study, the distance between two points, i.e. both ends of the long bone within a plane was measured following anatomical position. Figure 1 showed the measurements of dead bodies’ humerus length (H), femur length (F) and tibia length (T) in reformatted CT images through OsiriX using its measuring scales. The scales are corrected to 0.1 millimeter, however it was rounded up to .1 centimeter (cm) to equalize with the stature measurement of 0.1 cm as well as the stature measuring scale during postmortem examination following the anatomical position on the autopsy table.