Clin Osteol 2005; 10(4): 96-99

Dual X-ray absorptiometry (DXA) in children with kidney diseases -a problematic method of bone analysisReview articles

J. Feber, L. M. Ward

Dual energy X-ray absorptiometry (DXA) has been used in adult medicine to diagnose and monitor various types of osteoporosis. It is a very sensitive and accurate method to detect even small losses of bone mineral. Consequently, its use has been extended to pediatric medicine. The manufacturers provided reference values for healthy children in relation to chronological age. However, children with chronic disease often suffer from height retar­ dation and the use ofpre-established reference values in relation to age mayyield falsely low bone density results. Therefore, correction for actual height or bone volume is required for accurate interpretation of DXA results in children. Moreover, the amount of bone mineral or bone density may not be the most important parameter for the assessment of bone strength, which is influenced by bone geometry (the ratio between the cortical and trabecu­ lar bone as well as composition of trabecular microarchitecture) and muscle mass. DXA provides only limited information in this respect and does not differentiate between cortical and trabecular bone. Caution is warranted in the interpretation of DXA in children with stunted growth. The use of other macromorphometric techniques such as peripheral quantitative computer tomography (pQCT), as well as micromorphometry (bone histomorphometry) may be of advantage. In symptomatic patients the use of a classic X-ray should not be eliminated as a means of diagnosing fractures (such as ver­ tebral compression) despite normal results of DXA scans.

Keywords: bone mineral density, children.

Published: December 11, 2005  Show citation

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Feber J, Ward LM. Dual X-ray absorptiometry (DXA) in children with kidney diseases -a problematic method of bone analysis. Osteologický bulletin. 2005;10(4):96-99.
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