Introduction: Identification of gender is an important feature of the biological profile since it facilitates knowledge of other sex-dependent characteristics at death such as stature and age. The patella hasn't received as much attention as other bone elements regarding discriminant function analysis for sex estimation. This study aimed to discriminate gender discrimination using MRI patellar measurements in a convenient sample of the adult Egyptian population and to assess the accuracy of sex prediction for each of the right and left sides' measurements.
Methods: This was a cross-sectional study conducted on 128 participants (82 male and 46 female) during the period from 1st of July 2023 to 31st of December 2023. They were chosen by a convenient non-random sample from attendants of Radiology Department at Menoufia University Hospitals after exclusion of non-responders and application of exclusion criteria. 11 patellar measurements were taken off-axial Pd-fat sat and T2- weighted sagittal MRI scans of the knee.
Results: The mean age of the cases was 39.9 and 44.63 years for males and females respectively. The mean length, width, and thickness of patella in males were 4.38±0.34, 4.55±0.31, and 2.09±0.22 cm respectively. Values for females were 3.90±0.31, 4.10±0.29, and 1.85±0.23 cm respectively. The difference between males and females was significant in 9 out of 11 indices, where patellar length and width demonstrated far greater sexual dimorphism. As regards each side solely, it was found that right-side patellar measurements yielded higher accuracy in classifying males and females than left-side measurements (89.7% and 62% respectively). Left-side measurements yielded lower sensitivity and specificity values.
Conclusion: The results of the current study indicate that patellar measurements are sexually dimorphic and can be used as a diagnostic tool for sex estimation, with the patellar width followed by patellar length, then maximum axial perimeter, and the maximum axial area having the highest discriminant loading. Right-side patellar measurements yielded higher accuracy in classifying males and females than left-side measurements.
Keywords: gender, sex determination; patella measurement; magnetic resonance imaging; forensic identification.