Cortical bone geometry in asthmatic children

Quick, Jody L.

doi:10.1136/adc.2005.084996

Cited by 8 publications

(7 citation statements)

References 5 publications

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“…In healthy children, the age-related increase and gender differences in SSI have been shown at the radius [7,9,48] and tibia [49]. The SSI has been described in some paediatric patient groups [12,16,50] and in gymnasts versus controls [51]. Data from normal children [7] suggest that bone strength at the distal radius (as measured by SSI) may develop slowly and until 13 and 15 years, in females and males, respectively, may be inadequate to meet the mechanical challenges which threaten bone stability during the event of a fall.…”

Section: Discussionmentioning

confidence: 99%

“…Such reference data are essential for interpreting geometric parameters of cortical bone, which are important determinants of bone strength [26] and provide greater insight into healthy development and the effects of disease than solely measuring the distal radius site [13,16]. We present gender-specific reference data for the XCT-2000 pQCT scanner in a cohort of healthy white Caucasian children aged between 6 and 19 years from the UK.…”

Section: Discussionmentioning

confidence: 99%

“…There are a growing number of research studies using pQCT as a tool to understand disease aetiology in various patient groups [11][12][13][14][15][16][17][18][19][20][21]. For example, in pre-pubertal asthmatic children treated with high doses of inhaled glucocorticoids, we showed that distal radial trabecular BMD was not reduced [18], but that these children had smaller periosteal and endosteal circumferences and thicker cortices in comparison to controls [16]. We believe that the increased risk of non-vertebral fracture reported in asthmatic children [43] might be due to their smaller bones.…”

Section: Discussionmentioning

confidence: 99%

“…study of healthy skeletal development [1][2][3][4][5][6][7][8][9][10] and for the assessment of paediatric disorders associated with skeletal fragility [11][12][13][14][15][16][17][18][19][20][21]. pQCT is designed to measure peripheral skeletal sites such as the radius, tibia and femur.…”

mentioning

confidence: 99%

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A reference database for the Stratec XCT-2000 peripheral quantitative computed tomography (pQCT) scanner in healthy children and young adults aged 6–19 years

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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A reference database for the Stratec XCT-2000 peripheral quantitative computed tomography (pQCT) scanner in healthy children and young adults aged 6–19 years

et al. 2008

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“…The utility of axial and peripheral QCT has been shown in studies investigating differences in bone phenotype related to nutrition, aging, hormone status, chronic disease and treatment, i.e. the external modulators of bone and muscle; DXA has not always had the sensitivity to such detect differences (34,(43)(44)(45)(46)(47) . The agreement between DXA and QCT is generally poor (48,49) .…”

Section: Imaging and Musculoskeletal Phenotypementioning

confidence: 99%

Musculoskeletal phenotype through the life course: the role of nutrition

Ward

2011

Proc. Nutr. Soc.

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This review considers the definition of a healthy bone phenotype through the life course and the modulating effects of muscle function and nutrition. In particular, it will emphasise that optimal bone strength (and how that is regulated) is more important than simple measures of bone mass. The forces imposed on bone by muscle loading are the primary determinants of musculoskeletal health. Any factor that changes muscle loading on the bone, or the response of bone to loading results in alterations of bone strength. Advances in technology have enhanced the understanding of a healthy bone phenotype in different skeletal compartments. Multiple components of muscle strength can also be quantified. The critical evaluation of emerging technologies for assessment of bone and muscle phenotype is vital. Populations with low and moderate/high daily Ca intakes and/or different vitamin D status illustrate the importance of nutrition in determining musculoskeletal phenotype. Changes in mass and architecture maintain strength despite low Ca intake or vitamin D status. There is a complex interaction between body fat and bone which, in addition to protein intake, is emerging as a key area of research. Muscle and bone should be considered as an integrative unit; the role of body fat requires definition. There remains a lack of longitudinal evidence to understand how nutrition and lifestyle define musculoskeletal health. In conclusion, a life-course approach is required to understand the definition of healthy skeletal phenotype in different populations and at different stages of life.

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The change in energy absorbed post removal of metalwork in a simulated paediatric long bone fracture

Howieson

Jones

Theobald

2014

Journal of Children's Orthopaedics

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PurposeThe surgical treatment of paediatric fractures is increasing. Open reduction and internal fixation (ORIF) with plates and screws is long established, whilst the use of elastic stable intramedullary nailing (ESIN) has become increasingly popular. This study quantifies, in terms of the energy required to produce a fracture, the biomechanical sequelae of both techniques post removal of metalwork, to provide clinicians with evidence to guide post-operative advice.MethodsAn immature bovine model was adopted to ascertain whether these techniques exposed the bone to a greater re-fracture risk following removal of the device. Bones were prepared to reflect ORIF or ESIN techniques, or prepared intact for the acquisition of control data. Each bone was tested to failure at 90 °/s, with the absorbed energy then being calculated to determine the relative difference between each technique and versus control data. Data describing peak shear stress and torque were recorded.ResultsAbsorbed energy was reduced by 47 % in the ORIF group compared to both the control (p = 0.011) and ESIN (p = 0.018) groups. The peak shear stress and torque were also significantly different. All ORIF bones failed through drill holes, suggesting stress localisation around the defects.ConclusionThis study suggests that there is a significantly higher re-fracture risk following the removal of ORIF plates when compared to both ESIN and the control environment. Whilst this may reflect the intuitive view of many clinicians, this study provides a quantitative value of the reduction in strength and should help clinicians to appropriately caution patients and parents prior to surgery.

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Cortical bone geometry in asthmatic children

Cited by 8 publications

References 5 publications

A reference database for the Stratec XCT-2000 peripheral quantitative computed tomography (pQCT) scanner in healthy children and young adults aged 6–19 years

A reference database for the Stratec XCT-2000 peripheral quantitative computed tomography (pQCT) scanner in healthy children and young adults aged 6–19 years

Musculoskeletal phenotype through the life course: the role of nutrition

The change in energy absorbed post removal of metalwork in a simulated paediatric long bone fracture

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