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Bone densitometry in children and adolescents

Estrada, Andreaa,b; Ramnitz, Mary Scotta,b; Gafni, Rachel I.b

Current Opinion in Obstetrics and Gynecology: October 2014 - Volume 26 - Issue 5 - p 339–346
doi: 10.1097/GCO.0000000000000100
ADOLESCENT AND PEDIATRIC GYNECOLOGY: Edited by Paula J. Adams Hillard

Purpose of review Abnormalities in bone health are increasingly recognized in the pediatric population. Although the methodologies for assessing bone mineral density were originally developed for adults, great strides have been made in recent years, improving their applicability to children. Understanding these technologies, their interpretation, utility, and limitations is critical when assessing a child or adolescent with a suspected abnormality in bone mineral density.

Recent findings Improved normative databases that address some of the confounding variables in the growing and maturing child have solidified dual-energy X-ray absorptiometry as the preferred method for the assessment of bone mineral density in children. Consensus statements by expert panels now provide specific guidance to clinicians seeking to evaluate children with fractures or at risk for fractures. Although still primarily a research tool, continued development of quantitative computed tomography applications in pediatrics suggests there may be a complementary role for clinical use in the future.

Summary In the child or adolescent with a significant fracture history or a potential for fractures because of an underlying cause, clinicians now have guidelines and normative data to better focus their evaluation. Likewise, researchers can use this information to improve clinical trial design and interpretation of results.

aEunice Kennedy Shriver National Institute of Child Health and Human Development

bNational Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA

Correspondence to Rachel I. Gafni, MD, NIDCR, NIH, Building 30, Room 228, 30 Convent Dr MSC 4320, Bethesda, MD 20892-4320, USA. Tel: +1 301 594 9924; fax: +301 480 9962; e-mail: gafnir@mail.nih.gov

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