Can digital X-ray radiogrammetry be an alternative for dual-energy X-ray absorptiometry in the diagnosis of secondary low bone quality in children?

Leijten, Alex; Hampsink, Brieke; Janssen, Marcel; Klein, Willemijn M.; Draaisma, Jos M. Th.

doi:10.1007/s00431-019-03425-5

Cited by 19 publications

(10 citation statements)

References 29 publications

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“…DXR results were found to correlate well with BMD measurements by DXA in middle-aged and elderly women [ 37 ]. In children, BHI SDS has showed strong correlations with areal and height-adjusted BMD measurements by DXA, including low DXA values of z < –2 [ 38-42 ]. Similar correlations have been observed between BHI SDS and total BMD as assessed via pQCT [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Cortical Bone Mass is Low in Boys with Klinefelter Syndrome and Improves with Oxandrolone

Vogiatzi

Davis

Ross

2021

Journal of the Endocrine Society

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Introduction Klinefelter syndrome (KS) is the most common sex aneuploidy in men. Affected males have hypogonadism, and as a result, face an increased risk for osteoporosis and fractures. Androgen therapy is standard in adolescents and adults with KS but has not been used earlier in childhood. Objective To determine the effects of androgen treatment on bone mass in children with KS. Study design Randomized, double-blind, placebo-controlled clinical trial of oxandrolone (OX; 0.06 mg/kg daily; n= 38) versus placebo (PL; n= 40) for 2 years in boys with KS (ages 4- 12 years). Changes in bone mass were examined by digital x-ray radiogrammetry, which determines the Bone Health Index (BHI) and standard deviation scores (BHI SDS). Results BHI SDS was similar between groups at baseline (-0.46±1.1 vs. -0.34±1.0 OX vs. PL, p>0.05) and higher in the OX group at 2 years (-0.1 + 1.3 vs. -0.53 + 0.9, OX vs. PL, p< 0.01). At baseline, BHI SDS values of all subjects were not normally distributed with 25.7% of subjects plotted below -1 SDS (p<0.001), suggesting a deficit in bone mass. 13.5% of subjects had sustained a fracture and their BHI SDS was lower than those with no fractures (-1.6 + 1.3 vs. -0.3 + 1.0, p= 0.004). Conclusions Bone mass using BHI SDS is reduced in some children with KS and improves with OX. Since these individuals are at risk for osteoporosis, age-appropriate androgen replacement and future studies on bone health in children with KS should be further explored.

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Section: Discussionmentioning

confidence: 99%

Cortical Bone Mass is Low in Boys with Klinefelter Syndrome and Improves with Oxandrolone

Vogiatzi

Davis

Ross

2021

Journal of the Endocrine Society

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“…Secondary form and secondary low bone quality in children is due to systemic disease, their treatment, or indirect effects of systemic disease such as immobilization, poor nutrition etc. The course of osteoporosis in children is different than in adults due to varying bone mass (bone mass density, BMD) with age (18).…”

Section: Digital X-ray Radiogrammetry (Dxr)mentioning

confidence: 99%

Application of Artificial Intelligence in Pediatric Orthopaedic

Sharaf¹

2023

SVOAOR

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Background: Artificial intelligence has emerged as a promising tool in healthcare. The machine learning algorithms enable accurate diagnosis, imaging and treatment plans. Computer technology and digital software have come a long way in promoting care and prompt management of patients, and thereby enhancing their quality of life. The purpose of this review article is to provide a structured understanding about the current trends in Pediatric Orthopaedics based on the advanced AI led technology.Methodology: A total of 26 articles have been researched to write the current review, that are published in various journals globally. MEDLINE, PubMed, Scopus, Research Gate, Springer and many magazine blogs are some of the databases used. Results:The review article explores various AI-based digital tools and computer softwares that play a vital role in the field of pediatric orthopedics. The research is done under the following subheadings i) BoneView ii) Three-dimensional Model Reconstruction iii) BoneXpert iv) Digital X-Ray Radiogrammetry (DXR) v) Deep CNNs for tumor in children vi) Digital Tomosynthesis vii) 3D Printing Technology viii) Robots Assisting in Orthopaedic Surgery ix) OrthoNext Digital Platform. Conclusion:Currently, there is an increasing demand for quality medical treatment, especially in Pediatric Orthopaedics. The movement into the direction of digitalization and intelligence has begun in this field and computer technology has indeed brought many changes. The emergence of digital software and tools, Pediatric Orthopaedics has become more personalized and accurate. Significant changes have taken place in disease diagnosis, treatment modalities and implementation of surgery. The digital technology has great development potential in pediatric orthopaedics.

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“…To assess bone health on digital radiographs, different parameters have been proposed such as the Bone Health Index® (BHI) [ 84 , 85 ]. Studies comparing BHI determined by X-ray and BMD assessed by DXA showed contradictory results [ 86 – 92 ]. BHI seems to overestimate bone health impairment, also, the correlation with DXA measurements is not always good as it applies mainly to absolute values than to Z -scores.…”

Section: Diagnostic Techniques To Assess Bone Healthmentioning

confidence: 99%

Osteoporosis in children and adolescents: when to suspect and how to diagnose it

et al. 2022

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Early recognition of osteoporosis in children and adolescents is important in order to establish an appropriate diagnosis of the underlying condition and to initiate treatment if necessary. In this review, we present the diagnostic work-up, and its pitfalls, of pediatric patients suspected of osteoporosis including a careful collection of the medical and personal history, a complete physical examination, biochemical data, molecular genetics, and imaging techniques. The most recent and relevant literature has been reviewed to offer a broad overview on the topic. Genetic and acquired pediatric bone disorders are relatively common and cause substantial morbidity. In recent years, there has been significant progress in the understanding of the genetic and molecular mechanistic basis of bone fragility and in the identification of acquired causes of osteoporosis in children. Specifically, drugs that can negatively impact bone health (e.g. steroids) and immobilization related to acute and chronic diseases (e.g. Duchenne muscular dystrophy) represent major risk factors for the development of secondary osteoporosis and therefore an indication to screen for bone mineral density and vertebral fractures. Long-term studies in children chronically treated with steroids have resulted in the development of systematic approaches to diagnose and manage pediatric osteoporosis.Conclusions: Osteoporosis in children requires consultation with and/or referral to a pediatric bone specialist. This is particularly relevant since children possess the unique ability for spontaneous and medication-assisted recovery, including reshaping of vertebral fractures. As such, pediatricians have an opportunity to improve bone mass accrual and musculoskeletal health in osteoporotic children. What is Known:• Both genetic and acquired pediatric disorders can compromise bone health and predispose to fractures early in life.• The identification of children at risk of osteoporosis is essential to make a timely diagnosis and start the treatment, if necessary. What is New:• Pediatricians have an opportunity to improve bone mass accrual and musculoskeletal health in osteoporotic children and children at risk of osteoporosis.• We offer an extensive but concise overview about the risk factors for osteoporosis and the diagnostic work-up (and its pitfalls) of pediatric patients suspected of osteoporosis.

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Can digital X-ray radiogrammetry be an alternative for dual-energy X-ray absorptiometry in the diagnosis of secondary low bone quality in children?

Cited by 19 publications

References 29 publications

Cortical Bone Mass is Low in Boys with Klinefelter Syndrome and Improves with Oxandrolone

Cortical Bone Mass is Low in Boys with Klinefelter Syndrome and Improves with Oxandrolone

Application of Artificial Intelligence in Pediatric Orthopaedic

Osteoporosis in children and adolescents: when to suspect and how to diagnose it

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