Pediatric DXA: technique, interpretation and clinical applications

Binkovitz, Larry A.; Henwood, Maria J.; Sparke, Paul

doi:10.1007/s00247-008-0808-y

Cited by 31 publications

(22 citation statements)

References 130 publications

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“…21,22 Adult osteopenia is defined as a BMD that is 1 to 2.5 SDs below peak adult density, and osteoporosis is defined as 2.5 SD below peak density or lower. In children and adolescents, the influence of puberty on skeletal maturation introduces variability within age groups; thus, the more conservative diagnosis, low BMD, is preferred to osteopenia, particularly in the absence of fractures.…”

mentioning

confidence: 99%

Nutrition, Physical Activity, and Bone Mineral Density in Youth With Autistic Spectrum Disorders

Soden

Garrison

Egan

et al. 2012

Journal of Developmental &Amp; Behavioral Pediatrics

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confidence: 99%

Nutrition, Physical Activity, and Bone Mineral Density in Youth With Autistic Spectrum Disorders

Soden

Garrison

Egan

et al. 2012

Journal of Developmental &Amp; Behavioral Pediatrics

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“…Our finding of a mean of five disrupting factors per child, however, implies that DXA outcomes in children with severe neurological impairment and ID may be prone to inaccuracy. The lack of correlation between the amount of disrupting factors and BMD might be explained by the relatively small study population ( n = 27) and the fact that disrupting factors may lead to both overestimation and underestimation of bone density [6, 9, 11, 17–19, 27]. The question whether BMD outcome in children with severe neurological impairment and ID deviates in a systematic way as a result of disrupting factors can, therefore, not be thoroughly answered.…”

Section: Discussionmentioning

confidence: 99%

“…With DXA, after determining the bone mineral content (BMC) of body parts or the total body, a subsequent BMD is calculated by dividing BMC by bone area. However, it is known that the accuracy of BMD outcome in children is diminished by several factors, such as variability in skeletal size and body composition [6, 7]. Several studies have reported on additional artefacts and their influences on DXA results in the general population or in other patient groups [8–12].…”

Section: Introductionmentioning

confidence: 99%

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Lumbar spine and total-body dual-energy X-ray absorptiometry in children with severe neurological impairment and intellectual disability: a pilot study of artefacts and disrupting factors

Mergler

Rieken

Tibboel³

et al. 2012

Pediatr Radiol

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BackgroundChildren with severe neurological impairment and intellectual disability (ID) are susceptible for developing low bone mineral density (BMD) and fractures. BMD is generally measured with dual-energy X-ray absorptiometry (DXA).ObjectiveTo describe the occurrence of factors that may influence the feasibility of DXA and the accuracy of DXA outcome in children with severe neurological impairment and ID.Materials and methodsBased on literature and expert opinion, a list of disrupting factors was developed. Occurrence of these factors was assessed in 27 children who underwent DXA measurement.ResultsDisrupting factors that occurred most frequently were movement during measurement (82%), aberrant body composition (67%), small length for age (56%) and scoliosis (37%). The number of disrupting factors per child was mean 5.3 (range 1–8). No correlation was found between DXA outcomes and the number of disrupting factors.ConclusionFactors that may negatively influence the accuracy of DXA outcome are frequently present in children with severe neurological impairment and ID. No systematic deviation of DXA outcome in coherence with the amount of disrupting factors was found, but physicians should be aware of the possible influence of disrupting factors on the accuracy of DXA.

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“…HR-pQCT has also been used to provide an in-depth analysis of bone growth in children and adolescents, groups particularly affected by the limitations of DXA due to bone size differences and bone growth [45]. A consistent findings of these studies is the detection of transient deficits in cortical bone during puberty [13, 46–48].…”

Section: Clinical Applicationsmentioning

confidence: 99%

Clinical Imaging of Bone Microarchitecture with HR-pQCT

Nishiyama¹,

Shane²

2013

Curr Osteoporos Rep

152

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Osteoporosis, a disease characterized by loss of bone mass and structural deterioration, is currently diagnosed by dual-energy x-ray absorptiometry (DXA). However, DXA does not provide information about bone microstructure, which is a key determinant of bone strength. Recent advances in imaging permit the assessment of bone microstructure in vivo using high-resolution peripheral quantitative computed tomography (HR-pQCT). From these data, novel image processing techniques can be applied to characterize bone quality and strength. To date, most HR-pQCT studies are cross-sectional comparing subjects with and without fracture. These studies have shown that HR-pQCT is capable of discriminating fracture status independent of DXA. Recent longitudinal studies present new challenges in terms of analyzing the same region of interest and multisite calibrations. Careful application of analysis techniques and educated clinical interpretation of HR-pQCT results have improved our understanding of various bone-related diseases and will no doubt continue to do so in the future.

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Pediatric DXA: technique, interpretation and clinical applications

Cited by 31 publications

References 130 publications

Nutrition, Physical Activity, and Bone Mineral Density in Youth With Autistic Spectrum Disorders

Nutrition, Physical Activity, and Bone Mineral Density in Youth With Autistic Spectrum Disorders

Lumbar spine and total-body dual-energy X-ray absorptiometry in children with severe neurological impairment and intellectual disability: a pilot study of artefacts and disrupting factors

Clinical Imaging of Bone Microarchitecture with HR-pQCT

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