Which of the following are used for adult age estimation?

• A. Medial end of the clavicle
• B. Sternal rib end
• C. Pubic symphysis
• D. All of the above

Answer: (D)

Adult age estimation relies on progressive, recognizable changes in the skeleton after puberty. The pubic symphysis shows well-described morphological changes on its surface—fissuring, rounding of the lips, and surface relief—that change predictably with age and can be staged to estimate age. The sternal end of the rib exhibits age-related remodeling at the costosternal junction, with changes to the rim and articular margins that can be graded to derive an age range. The medial end of the clavicle is notable because its epiphyseal union and surface remodeling occur late, providing useful age indicators for older individuals and improving precision when evaluated with imaging. Because these sites age along different timelines and provide complementary information, using all of them together yields a more reliable adult age estimate.