Association of Bone Mineral Density and Pediatric Fractures

Sd, Cook; Af, Harding; El, Morgan; Hj, Doucet; Jt, Bennett; O’Brien, M.; Ka, Thomas

doi:10.1097/01241398-198707000-00009

Cited by 40 publications

(22 citation statements)

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“…Several studies have compared the DXA BMD of normal children and adolescents with forearm fractures to that of age-matched controls without fractures. Most [35][36][37][38][39], but not all [40,41], found that mean DXA BMD was significantly lower in children with forearm fractures than in controls.…”

Section: Skeletal Modeling During Growth and Developmentmentioning

confidence: 90%

A structural approach to the assessment of fracture risk in children and adolescents with chronic kidney disease

Leonard

2007

Pediatr Nephrol

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Children with chronic kidney disease (CKD) have multiple risk factors for impaired accretion of trabecular and cortical bone. CKD during childhood poses an immediate fracture risk and compromises adult bone mass, resulting in significantly greater skeletal fragility throughout life. Highturnover disease initially results in thickened trabeculae, with greater bone volume. As disease progresses, resorption cavities dissect trabeculae, connectivity degrades, and bone volume decreases. Increased bone turnover also results in increased cortical porosity and decreased cortical thickness. Dual-energy X-ray absorptiometry (DXA)-based measures of bone mineral density (BMD) are derived from the total bone mass within the projected bone area (g/cm 2 ), concealing distinct disease effects in trabecular and cortical bone. In contrast, peripheral quantitative computed tomography (pQCT) estimates volumetric BMD (vBMD, g/cm 3 ), distinguishes between cortical and trabecular bone, and provides accurate estimates of cortical dimensions. Recent data have confirmed that pQCT measures of cortical vBMD and thickness provide substantially greater fracture discrimination in adult dialysis patients compared with hip or spine DXA. The following review considers the structural effects of renal osteodystrophy as it relates to fracture risk and the potential advantages and disadvantages of DXA and alternative measures of bone density, geometry, and microarchitecture, such as pQCT, micro-CT (μCT), and micro magnetic resonance imaging (μMRI) for fracture risk assessment.

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Section: Skeletal Modeling During Growth and Developmentmentioning

confidence: 90%

A structural approach to the assessment of fracture risk in children and adolescents with chronic kidney disease

Leonard

2007

Pediatr Nephrol

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“…Interpretation of bone density in children with regard to fracture risk is more difficult and is best done using age and sex standardized normal ranges reported as Z scores. Associations have been inconsistent or negative with total or traumatic fractures [21][22][23][24], other upper limb fractures [19•], and fractures in prepubertal children [17,25]. In the only prospective study to date, areal BMD was a predictor of new total fractures over a 4-year followup period [20••].…”

Section: Bone Measuresmentioning

confidence: 99%

Growth, children, and fractures

Jones

2004

Curr Osteoporos Rep

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Fractures in childhood have long been considered an unavoidable consequence of growth. Studies in recent years have documented the epidemiology of these very common fractures and have also documented considerable variation by fracture type and from country to country. There have also been a number of studies aimed at identifying risk factors particularly for the most common distal forearm fracture. These studies have consistently associated bone mineral density with these fractures. Other possible risk factors include obesity, physical inactivity, sports, cola beverages, calcium intake, risk taking, and coordination. While prospective studies are required to confirm these risk factors, accumulating evidence now suggests that a substantial proportion of fractures in children are preventable.

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“…193 A study of ultra-orthodox Jewish adolescents with very little physical activity, measured in walking hours, found that the lumbal BMD was significantly decreased, especially in boys. 166 The relationship between bone mineral density and child fractures have been analysed with different results 32,90 and is further discussed in the chapter on fracture.…”

Section: Activity Versus Inactivitymentioning

confidence: 99%

“…90 Cook found no differense in bone density measured in trabecular bone between those with or without fractures. 32 Interpretation of bone density in children is done using age and sex standardized normal ranges reported as Z scores, and is usually measured using dual energy x-ray absorptiometry DXA. Fracture risk increases with 1,5 to 1,6 times per SD decrease in areal /volumetric BMD.…”

Section: Bone Mineral Density Bone Structure and Fracturementioning

confidence: 99%

Child injuries in Bergen, Norway

Brudvik

2000

Injury

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Association of Bone Mineral Density and Pediatric Fractures

Cited by 40 publications

References 0 publications

A structural approach to the assessment of fracture risk in children and adolescents with chronic kidney disease

A structural approach to the assessment of fracture risk in children and adolescents with chronic kidney disease

Growth, children, and fractures

Child injuries in Bergen, Norway

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