Bone Densitometry in Growing Patients: Guidelines for by Aenor J. Sawyer

By Aenor J. Sawyer

Bone Densitometry in growing to be sufferers is the 1st source to be had for specialist opinion at the use of twin power x-ray absorptiometry (DXA) for comparing bone density in kids and children. Written by way of across the world famous pediatric bone researchers and clinicians, this quantity is exclusive in its particular consciousness to the myriad demanding situations of measuring and comparing bone density within the pediatric sufferer. there's enough technical aspect offered during this quantity to allow the institution of a pediatric DXA heart or the correct usage of DXA test info in present medical perform. the quantity opens with a short creation to basic thoughts when it comes to bone wellbeing and fitness in youngsters and an outline of all at the moment to be had densitometry recommendations utilized in comparing youngsters. next chapters specialize in symptoms for DXA stories in teenagers and the optimum tools for buying, interpreting, reading, and reporting those scans. present and destiny study purposes of DXA and different modalities for learning pediatric bone healthiness also are mentioned. an in depth appendix offers helpful pediatric reference information, pattern types to be used in buying and reporting DXA facts, listings of helpful and proper pediatric bone web content, and a entire bibliography. This quantity, that's the 1st pediatric DXA reference released, optimizes the actual and accountable use of DXA in little ones as a device within the scientific administration of bone fragility, and thereby paves the way in which for the longer term improvement of applicable intervention and remedy courses for this inhabitants.

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Because there may be regional differences in bone mass and strength, selection of skeletal site to scan is important. For example, in children with juvenile idiopathic arthritis, who are most likely to suffer a vertebral crush fracture (134,135), measurement of spinal trabecular bone should be a priority. Any measurement that does not include the spine is less likely to be sensitive to the bone changes that occur. Diagnostic agreement between axial and peripheral skeletal sites may also differ depending on the child’s phase of skeletal development.

The trabecular vBMD, measured by QCT, is a composite of the amount of bone and marrow per voxel. The measurement is composite because of the relatively small size of trabeculae compared to the voxel, resulting in marrow being included in the measurement. Because marrow fat is limited in children, age-related marrow changes in fat composition should not confound spinal vBMD measurements in children as significantly as they do in adults (42). The original body CT scanners used rotate-translate technology and permitted only 2D slices to be obtained; the procedure took about 15 min.

18. Strauss AJ, Su JT, Dalton VM, Gelber RD, Sallan SE, Silveran LB. Bony morbidity in children treated for acute lymphoblastic leukemia. J Clin Oncol 2001;19,3066–3072. 19. van der Sluis I, van den Heuvel-Eibrink M, Hahlen K, Krenning E, de Muinck Keizer-Schrama S. Bone mineral density, body composition, and height in long-term survivors of acute lymphoblastic leukemia in childhood. Med Pediatr Oncol 2000;35:415–420. 20. Heaney RP, Abrams S, Dawson-Hughes B, et al. Peak bone mass. Osteoporosis Int 2000;11:985–1009.

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