Sex Determination Based on the Radiographic Examination of the Metatarsal Bones: a Retrospective Study in Ghanaian Hospitals
DOI:
https://doi.org/10.54450/saradio.2026.64.1.993Keywords:
Metatarsals, Sex determination, Anthropology, Archaeology, Foot X-rayAbstract
Background. Sex determination, the process of classifying human remains as either male or female, is a fundamental step in forensic anthropology and archaeological investigations. There is a paucity of literature on the use of metatarsal bones in sex determination. This study, therefore, assessed the accuracy of using metatarsal bones for forensic sex determination in the Ghanaian setting. In this study the accuracy of metatarsal bone length-to-width (L/W) ratios for sex determination, age-related reliability, and sexual dimorphism in a Ghanaian population were evaluated.
Methods. A retrospective cross-sectional design was employed, analysing radiographic image data of 256 individuals (54.3% male, 45.7% female) aged between 20 and 60 years. Measurements of the first (M1) and second (M2) metatarsals were obtained from digital foot radiographs, and L/W ratios were calculated. Statistical analyses included receiver operating characteristic (ROC) curve analysis to assess discriminative power, regression analysis with interaction terms to evaluate age effects, and multivariate analysis of variance (MANOVA) to examine sexual dimorphism.
Results. Most participants (56.6%) were in early adulthood (ages 20–41). The second metatarsal (M2) was longer than the first (M1) (M2: 70.13 ± 6.38 mm vs. M1: 57.84 ± 5.99 mm), while M1 was wider than M2 (M1: 19.64 ± 2.39 mm vs. M2: 13.73 ± 2.14 mm) for both males and females. Males had bigger M1 and M2 than females, lengthwise and in width. ROC analysis revealed poor accuracy for sex determination, with area under the curve (AUC) values of 0.43 for M1 and 0.52 for M2. Age did not significantly influence the reliability of L/W ratios (p > 0.05). MANOVA confirmed significant sexual dimorphism in metatarsal dimensions (Wilks’ λ = 0.88, p < 0.0001), with males exhibiting larger bone sizes (length: +12 – 14%; width: +15 – 18%).
Conclusion. Metatarsal bone measurements alone are insufficient for reliable sex determination in forensics, particularly in the Ghanaian context. However, when used in conjunction with other skeletal indicators, they can contribute to forensic investigations. Further research on population-specific variations is recommended.
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