Evaluation of computed tomography images of calcaneus for estimation of sex

Estimation of sex from bone remnants after medicolegal issues or mass disasters constitute a challenge. Our objective was to investigate if morphometric measurements performed on computed tomography (CT) images of the calcaneus can be useful for sex estimation. The measurements were performed on CT images of calcaneus bones of 489 patients (203 women, 286 men). The parameters under investigation were maximum length (MAXL), load arm length (LAL), minimum breadth (MINB), body height (BH), maximum height (MAXH), dorsal articular facet length (DAFL), dorsal articular facet breadth (DAFB), and cuboidal facet height (CFH). All parameters were remarkably increased in men compared to women (p < 0.001, for all). The highest performances for sex estimation were displayed by DAFL (92.8%) and BH (92.6%). The concomitant use of variables MAXL, BH, CFH, and DAFL revealed accuracy as high as 96% for gender discrimination. We suggest that morphometric measurements performed on CT images of the calcaneus can provide useful data for the estimation of sex.