Pediatric DXA: technique and interpretation

Abstract

This article reviews dual X-ray absorptiometry (DXA) technique and interpretation with emphasis on the considerations unique to pediatrics. Specifically, the use of DXA in children requires the radiologist to be a "clinical pathologist" monitoring the technical aspects of the DXA acquisition, a "statistician" knowledgeable in the concepts of Z-scores and least significant changes, and a "bone specialist" providing the referring clinician a meaningful context for the numeric result generated by DXA. The patient factors that most significantly influence bone mineral density are discussed and are reviewed with respect to available normative databases. The effects the growing skeleton has on the DXA result are also presented. Most important, the need for the radiologist to be actively involved in the technical and interpretive aspects of DXA is stressed. Finally, the diagnosis of osteoporosis should not be made on DXA results alone but should take into account other patient factors.

Bone mineral density acquisition in peripubertal female rhythmic gymnasts is directly associated with plasma IGF1/IGF-binding protein 3 ratio

“…Lastly, current DXA technology provides a real rather than a volumetric density measurement. It thus does not take into account all the parameters related to the growing skeleton, particularly the changes in bone size that occur during normal growth (35). This is one of the major limitations of pediatric DXA (35).…”

“…It thus does not take into account all the parameters related to the growing skeleton, particularly the changes in bone size that occur during normal growth (35). This is one of the major limitations of pediatric DXA (35). More recent technologies such as peripheral quantitative computed tomography (pQCT), which directly evaluates volumetric density, may be very useful in analyzing the real effect of intense training on bone mass acquisition, but this technology is not widely accessible at this time.…”

Insulin –like Growth Factor 1 in Adolescent Girls with Anorexia Nervosa: Relation to Bone Formation Parameters

“…(1) Artifacts including enteric tubes, metallic objects, and jewelry were excluded from the image [12].…”

Dual-Energy X-Ray Absorptiometry Interpretation: A Simple Equation for Height Correction in Preteenage Children

“…However, ease of use, relative low cost, and minimal radiation exposure extended its application to pediatric practice (2,3). Although DXA measurements are surrogates for bone mineral density (BMD) but not bone quality (1), in adults DXA assessments of BMD (1) and bone mineral content (BMC) (4) predict fracture risk.…”