German Pediatric Reference Data for Quantitative Transverse Transmission Ultrasound of Finger Phalanges

Abstract

Quantitative ultrasound (QUS) of the finger phalanges is a useful tool in the assessment of disease- or age-related deterioration of bone. For studying the impact of juvenile diseases or growth disorders affecting the skeleton, a reference database for QUS parameters is needed. The aim of this study was to establish a calibrated reference database of parameters of transverse ultrasound transmission through juvenile finger phalanges. A total of 1328 children (650 females, 678 males; ages 3-17 years) were measured in Heidelberg and Kiel in order to establish a German reference database. Highly significant gender-specific correlations (p<0.0001) were found between the QUS parameters amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT) versus age, body height and body mass index (BMI). For AD-SoS the correlation coefficients were R2 = 0.64 against age in males and R2 = 0.73 in females, R2 = 0.60 against body height in males and R2 = 0.68 in females, and R2 = 0.19 against BMI in males and R2 = 0.23 in females. For BTT the correlation coefficients were R2 = 0.74 against age in males and R2 = 0.79 in females, R2 = 0.75 against body height in males and R2 = 0.77 in females, and R2 = 0.32 against BMI in males and R2 = 0.35 in females. Age and height were the strongest determinants of QUS results. Gender-specific differences were observed in AD-SoS (significant for ages 11-14 years and for 150-170 cm body height) and in BTT (significant for ages 7 and 11-17 years and for 160-170 cm body height). Tables of QUS parameters versus age and height can serve as a basis for the evaluation of the impact of skeletal diseases or growth disorders on phalangeal QUS. Depending on the type of disease or growth disorder, measurement results can be compared with age- or height- specific reference data. In this way a simple and radiation-free assessment of juvenile skeletal disorders using quantitative ultrasound might be possible in the future.

Quantitative Ultrasound at the Hand Phalanges in Adolescent Girls is Related to Their Overall Physical Fitness

“…These anthropometric factors could be responsible for the bet- ter bone status assessed by QUS. There was no correlation between Ad-SoS and BMI or body mass in the girls from our study, contrary to other studies [4][5][6]. Physical fitness could influence Ad-SoS in our group, since a statistically significant positive correlation between them was shown.…”

“…This is influenced by a number of factors like body mass, sexual development, physical fitness and environmental factors [2,5,6,18]. The impact of the place of residence could influence physical development, since the girls from our study group had generally higher weight, height and BMI than the controls.…”

“…On the other hand, in the time of puberty, the physical activity of girls typically decreases, which can negatively influence bone mass. Various diseases can result in lower bone mass and size [3][4][5][6]. Worsened mechanical properties of bones were found, using ultrasound, in children and adolescents suffering from different diseases such as diabetes mellitus, chronic renal failure or leukemia survivors [7][8][9].…”

Bone status in adolescents with type 1 diabetes

“…It was calculated by means of a standard Z-score transformation using mean value and standard deviation appropriate for age and sex groups. Normative data for phalangeal quantitative ultrasound variables were published [12,16,18,19]. The coefficient of variation (CV%) for QUS measurements was 0.64%.…”

Bone mineral status in breast-fed infants: influence of vitamin D supplementation

“…Other authors reported that the difference in QUS parameters between genders become significant in older age groups, particularly at puberty (Baroncelli et al, 2001;Barkmann et al, 2002).…”