Ultrasound bone measurement in pediatric subjects

Abstract

Ultrasound bone measurement in healthy (n = 71) and osteopenic (n = 18) children aged 6 through 13 years of both sexes has been evaluated using the Achilles densitometer (Lunar Corporation). Measurements on the os calcis included speed of sound (SOS), broadband ultrasound attenuation (BUA), and a calculated "stiffness" index. The Achilles was adapted for children by a special positioning procedure that included the use of foot shims, and beam collimation on the receiving transducer. The precision of ultrasound results was comparable to that in adults (0.2% for SOS, 1.5% for BUA, and 1.8% for stiffness). SOS, BUA, and stiffness values increased with age in both sexes. Ultrasound measurements were correlated with bone mineral density (BMD in g/cm2) of the heel, AP spine (L2-L4), and total body by dual X-ray absorptiometry (DXA) densitometry (Lunar DPX-L). SOS, BUA, and stiffness measurements were significantly lower in osteopenic children (Z approximately -1.9 to -2.5) (P < 0.0001) than in normal age-matched controls. Total body BMD showed a higher Z-score than stiffness (-3.3 versus -2.5), but stiffness showed a greater percentage decrease (-30% versus -18%). In conclusion, ultrasound measurements of bone in children provide both good precision and discrimination of normals from osteopenic patients.

A multiscale analytical approach for bone remodeling simulations: Linking scales from collagen to trabeculae

“…3(b) and Table 3. The stiffness increase with age as predicted in Table 3 agrees well with that observed in in-vivo ultrasound experiments on the os calcis bones of children aged 6 through 13 years [38].…”

Agreement Between Dual-Energy X-Ray Absorptiometry and Quantitative Ultrasound to Evaluate Bone Health in Adolescents: The PRO-BONE Study

“…Both feet were measured twice in the same session (right, left, right, left), and the mean was used for statistical analyses. The precision data for QUS in children have been reported as 0.2% for SOS, 1.5% for BUA, and 1.8% for stiffness (13).…”

Reference values of bone stiffness index and C-terminal telopeptide in healthy European children

“…The pathological meaning of these values still needs to be evaluated. Only one study investigated SI values in children with bone disorders: Jaworski et al 27 observed a mean SI of 50.6 ± 13.7 in eighteen 6-to 13-year old children having osteopenia. According to these findings, our reference values for 5.5-9.5-year-old girls in the 1st age-specific SI percentile (range: 49.9-64.9) are close to this pathological value for osteopenia.…”

“…24 Besides the difference between QUS and DXA measurements assessing bone status, bone stiffness showed good correlations with aBMD assessed by DXA in adults 25 and children. 26,27 Furthermore, it revealed to be highly prognostic with regard to bone fractures in adults 28 and proved to be a valid measure for the risk for osteopenia in young patients. 27 Up to now, QUS references were established mainly for adults but are barely available for children and adolescents.…”

“…26,27 Furthermore, it revealed to be highly prognostic with regard to bone fractures in adults 28 and proved to be a valid measure for the risk for osteopenia in young patients. 27 Up to now, QUS references were established mainly for adults but are barely available for children and adolescents. 20,24 According to the recommendation of the International Society for Clinical Densitometry, a combined assessment of physical measures and biochemical bone metabolic markers is useful to identify a reduced skeletal development in children.…”