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Osteoporosis International
Published in: Osteoporosis International 8/2009

01-08-2009 | Original Article

A reference database for the Stratec XCT-2000 peripheral quantitative computed tomography (pQCT) scanner in healthy children and young adults aged 6–19 years

Authors: R. L. Ashby, K. A. Ward, S. A. Roberts, L. Edwards, M. Z. Mughal, J. E. Adams

Published in: Osteoporosis International | Issue 8/2009

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Abstract

Summary

We have produced paediatric reference data for forearm sites using the Stratec XCT-2000 peripheral quantitative computed tomography scanner. These data are intended for clinical and research use and will assist in the interpretation of bone mineral density and bone geometric parameters at the distal and mid-shaft radius in children and young adults aged between 6–19 years.

Introduction

Peripheral quantitative computed tomography (pQCT) provides measurements of bone mineral content (BMC), density (BMD) and bone geometry. There is a lack of reference data available for the interpretation of pQCT measurements in children and young adults. The aim of this study was to provide reference data at the distal and mid-shaft radius.

Methods

pQCT was used to measure the 4% and 50% sites of the non-dominant radius in a cohort of healthy white Caucasian children and young adults aged between 5 and 25 years. The lambda, mu, sigma (LMS) technique was used to produce gender-specific reference centile curves and LMS tables for calculating individual standard deviations scores.

Results

The study population consisted of 629 participants (380 males). Reference centile curves were produced; total and trabecular BMD for age (distal radius) and for age and height, bone area (distal and mid-shaft radius), cortical area, cortical thickness, BMC, axial moment of inertia, stress–strain index and muscle area (mid-shaft radius).

Conclusions

We present gender-specific databases for the assessment of the distal and mid-shaft radius by pQCT. These data can be used as control data for research studies and allow the clinical interpretation of pQCT measurements in children and young adults by age and height.
Appendix
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Literature
1.
Binkley TL, Specker BL, Wittig TA (2002) Centile curves for bone densitometry measurements in healthy males and females ages 5–22 yr. J Clin Densitom 5:343–353PubMedCrossRef
2.
Fujita T, Fujii Y, Goto B (1999) Measurement of forearm bone in children by peripheral computed tomography. Calcif Tissue Int 64:34–39PubMedCrossRef
3.
Macdonald HM, Kontulainen SA, Mackelvie-O’Brien KJ, Petit MA, Janssen P, Khan KM, McKay HA (2005) Maturity- and sex-related changes in tibial bone geometry, strength and bone-muscle strength indices during growth: a 20-month pQCT study. Bone 36:1003–1011PubMedCrossRef
4.
Moyer-Mileur L, Xie B, Ball S, Bainbridge C, Stadler D, Jee WS (2001) Predictors of bone mass by peripheral quantitative computed tomography in early adolescent girls. J Clin Densitom 4:313–323PubMedCrossRef
5.
Neu CM, Manz F, Rauch F, Merkel A, Schoenau E (2001) Bone densities and bone size at the distal radius in healthy children and adolescents: a study using peripheral quantitative computed tomography. Bone 28:227–232PubMedCrossRef
6.
Neu CM, Rauch F, Manz F, Schoenau E (2001) Modeling of cross-sectional bone size, mass and geometry at the proximal radius: a study of normal bone development using peripheral quantitative computed tomography. Osteoporos Int 12:538–547PubMedCrossRef
7.
Rauch F, Neu C, Manz F, Schoenau E (2001) The development of metaphyseal cortex—implications for distal radius fractures during growth. J Bone Miner Res 16:1547–1555PubMedCrossRef
8.
Rauch F, Schoenau E (2005) Peripheral quantitative computed tomography of the distal radius in young subjects—new reference data and interpretation of results. J Musculoskelet Neuronal Interact 5:119–126PubMed
9.
Schoenau E, Neu CM, Rauch F, Manz F (2001) The development of bone strength at the proximal radius during childhood and adolescence. J Clin Endocrinol Metab 86:613–618PubMedCrossRef
10.
Wang Q, Alen M, Nicholson P, Lyytikainen A, Suuriniemi M, Helkala E, Suominen H, Cheng S (2005) Growth patterns at distal radius and tibial shaft in pubertal girls: a 2-year longitudinal study. J Bone Miner Res 20:954–961PubMedCrossRef
11.
Bechtold S, Ripperger P, Bonfig W, Pozza RD, Haefner R, Schwarz HP (2005) Growth hormone changes bone geometry and body composition in patients with juvenile idiopathic arthritis requiring glucocorticoid treatment: a controlled study using peripheral quantitative computed tomography. J Clin Endocrinol Metab 90:3168–3173PubMedCrossRef
12.
Binkley T, Johnson J, Vogel L, Kecskemethy H, Henderson R, Specker B (2005) Bone measurements by peripheral quantitative computed tomography (pQCT) in children with cerebral palsy. J Pediatr 147:791–796PubMedCrossRef
13.
Brennan BM, Mughal Z, Roberts SA, Ward K, Shalet SM, Eden TO, Will AM, Stevens RF, Adams JE (2005) Bone mineral density in childhood survivors of acute lymphoblastic leukemia treated without cranial irradiation. J Clin Endocrinol Metab 90:689–694PubMedCrossRef
14.
Heap J, Murray MA, Miller SC, Jalili T, Moyer-Mileur LJ (2004) Alterations in bone characteristics associated with glycemic control in adolescents with type 1 diabetes mellitus. J Pediatr 144:56–62PubMedCrossRef
15.
Moyer-Mileur LJ, Dixon SB, Quick JL, Askew EW, Murray MA (2004) Bone mineral acquisition in adolescents with type 1 diabetes. J Pediatr 145:662–669PubMedCrossRef
16.
Quick JL, Ward KA, Adams JE, Mughal MZ (2006) Cortical bone geometry in asthmatic children. Arch Dis Child 91:346–348PubMedCrossRef
17.
Rauch F, Land C, Cornibert S, Schoenau E, Glorieux FH (2005) High and low density in the same bone: a study on children and adolescents with mild osteogenesis imperfecta. Bone 37:634–641PubMedCrossRef
18.
Reilly SM, Hambleton G, Adams JE, Mughal MZ (2001) Bone density in asthmatic children treated with inhaled corticosteroids. Arch Dis Child 84:183–184PubMedCrossRef
19.
Roth J, Palm C, Scheunemann I, Ranke MB, Schweizer R, Dannecker GE (2004) Musculoskeletal abnormalities of the forearm in patients with juvenile idiopathic arthritis relate mainly to bone geometry. Arthritis Rheum 50:1277–1285PubMedCrossRef
20.
Schwahn B, Rauch F, Wendel U, Schonau E (2002) Low bone mass in glycogen storage disease type 1 is associated with reduced muscle force and poor metabolic control. J Pediatr 141:350–356PubMedCrossRef
21.
Schweizer R, Martin DD, Schwarze CP, Binder G, Georgiadou A, Ihle J, Ranke MB (2003) Cortical bone density is normal in prepubertal children with growth hormone (GH) deficiency, but initially decreases during GH replacement due to early bone remodeling. J Clin Endocrinol Metab 88:5266–5272PubMedCrossRef
22.
Engelke K, Gluer CC (2006) Quality and performance measures in bone densitometry: part 1: errors and diagnosis. Osteoporos Int 17:1283–1292PubMedCrossRef
23.
Gilsanz V (1998) Bone density in children: a review of the available techniques and indications. Eur J Radiol 26:177–182PubMedCrossRef
24.
Schoenau E, Neu CM, Beck B, Manz F, Rauch F (2002) Bone mineral content per muscle cross-sectional area as an index of the functional muscle-bone unit. J Bone Miner Res 17:1095–1101PubMedCrossRef
25.
Schiessl H, Ferretti J, Tysarczyk-Niemeyer G, Willnecker J (1996) Noninvasive bone strength index as analyzed by peripheral computed tomography (pQCT). In: Schoenau E (ed) Paediatric osteology: new developments in diagnostics and therapy. Elsevier Science B.V., Amsterdam, pp 141–146
26.
Burr DB, Turner CH (2003) Biomechanics of bone. In: Favus MJ (ed) Primer on the metabolic bone diseases and disorders of mineral metabolism. The American Society for Bone and Mineral Research, Philadelphia, pp 58–64
27.
National Osteoporosis Society (2004) A practical guide to bone densitometry in children. Camerton, Bath, UK
28.
Watson SJ, Jones AL, Oatway WB, Hughes JS (2005) Ionising radiation exposure of the UK Population: 2005 review. Health Protection Agency Centre for Radiation, Chemical and Environmental Hazards Radiation Protection Division, Chilton, Didcot, Oxfordshire, UK
29.
Lettgen B, Neudorf U, Hosse R, Peters S, Reiners C (1996) Bone density in children and adolescents with rheumatic diseases. Preliminary results of selective measurement of trabecular and cortical bone using peripheral computerized tomography. Klin Padiatr 208:114–117PubMedCrossRef
30.
Zemel B, Bass S, Binkley T, Ducher G, Macdonald H, McKay H, Moyer-Mileur L, Shepherd J, Specker B, Ward K, Hans D (2008) Peripheral quantitative computed tomography in children and adolescents: the 2007 ISCD Pediatric Official Positions. J Clin Densitom 11:59–74PubMedCrossRef
31.
Moyer-Mileur LJ, Quick JL, Murray MA (2008) Peripheral quantitative computed tomography of the tibia: pediatric reference values. J Clin Densitom 11:283–294PubMedCrossRef
32.
Ward KA, Ashby RL, Roberts SA, Adams JE, Zulf Mughal M (2007) UK reference data for the Hologic QDR Discovery dual-energy x ray absorptiometry scanner in healthy children and young adults aged 6–17 years. Arch Dis Child 92:53–59PubMedCrossRef
33.
Phillimore P, Beattie A, Townsend P (1994) Widening inequality of health in northern England, 1981–91. BMJ 308:1125–1128PubMed
34.
35.
Cole TJ, Freeman JV, Preece MA (1995) Body mass index reference curves for the UK, 1990. Arch Dis Child 73:25–29PubMedCrossRef
36.
Freeman JV, Cole TJ, Chinn S, Jones PR, White EM, Preece MA (1995) Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child 73:17–24PubMedCrossRef
37.
Stratec Medizintechnik GmbH (2004) XCT 2000 Manual Software Version 5.50
38.
Cole TJ, Green PJ (1992) Smoothing reference centile curves: the LMS method and penalized likelihood. Stat Med 11:1305–1319PubMedCrossRef
39.
Ashby RL (2006) Growth and development of the skeleton in normal children. Unpublished PhD thesis, The University of Manchester
40.
Slemenda CW, Reister TK, Hui SL, Miller JZ, Christian JC, Johnston CC Jr (1994) Influences on skeletal mineralization in children and adolescents: evidence for varying effects of sexual maturation and physical activity. J Pediatr 125:201–207PubMedCrossRef
41.
Leonard MB, Shults J, Elliott DM, Stallings VA, Zemel BS (2004) Interpretation of whole body dual energy X-ray absorptiometry measures in children: comparison with peripheral quantitative computed tomography. Bone 34:1044–1052PubMedCrossRef
42.
Ward KA, Adams JE, Hangartner TN (2005) Recommendations for thresholds for cortical bone geometry and density measurement by peripheral quantitative computed tomography. Calcif Tissue Int 77:275–280PubMedCrossRef
43.
van Staa TP, Bishop N, Leufkens HG, Cooper C (2004) Are inhaled corticosteroids associated with an increased risk of fracture in children? Osteoporos Int 15:785–791PubMedCrossRef
44.
Muller ME, Webber CE, Bouxsein ML (2003) Predicting the failure load of the distal radius. Osteoporos Int 14:345–352PubMedCrossRef
45.
Wilhelm G, Felsenberg D, Bogusch G, Willnecker J, Thaten J, Gummert P (1999) Biomechanical examinations for validation of the bone strength strain index SSI, calculated by peripheral quantitative computed tomography. In: Lyritis GP (ed) Musculoskeletal interactions II. Hylonome, Athens, pp 105–108
46.
Horikoshi T, Endo N, Uchiyama T, Tanizawa T, Takahashi HE (1999) Peripheral quantitative computed tomography of the femoral neck in 60 Japanese women. Calcif Tissue Int 65:447–453PubMedCrossRef
47.
Di Leo C, Tarolo GL, Bagni B, Bestetti A, Tagliabue L, Pietrogrande L, Pepe L (2002) Peripheral quantitative Computed Tomography (PQCT) in the evaluation of bone geometry, biomechanics and mineral density in postmenopausal women. Radiol Med (Torino) 103:233–241
48.
Fricke O, Sumnik Z, Tutlewski B, Stabrey A, Remer T, Schoenau E (2008) Local body composition is associated with gender differences of bone development at the forearm in puberty. Horm Res 70:105–111PubMedCrossRef
49.
Macdonald H, Kontulainen S, Petit M, Janssen P, McKay H (2006) Bone strength and its determinants in pre- and early pubertal boys and girls. Bone 39:598–608PubMedCrossRef
50.
Roth J, Linge M, Tzaribachev N, Schweizer R, Kuemmerle-Deschner J (2007) Musculoskeletal abnormalities in juvenile idiopathic arthritis—a 4-year longitudinal study. Rheumatology (Oxford) 46:1180–1184CrossRef
51.
Ward KA, Roberts SA, Adams JE, Mughal MZ (2005) Bone geometry and density in the skeleton of pre-pubertal gymnasts and school children. Bone 36:1012–1018PubMedCrossRef
52.
Marjanovic E, Ward K, Adams J (2008) The impact of accurate positioning on measurements made by peripheral QCT in the distal radius. Osteoporos Int [Epub ahead of print], Nov 4
53.
Rauch F, Tutlewski B, Fricke O, Rieger-Wettengl G, Schauseil-Zipf U, Herkenrath P, Neu CM, Schoenau E (2001) Analysis of cancellous bone turnover by multiple slice analysis at distal radius: a study using peripheral quantitative computed tomography. J Clin Densitom 4:257–262PubMedCrossRef
54.
Rauch F, Travers R, Munns C, Glorieux FH (2004) Sclerotic metaphyseal lines in a child treated with pamidronate: histomorphometric analysis. J Bone Miner Res 19:1191–1193PubMedCrossRef
55.
Davies JH, Gregory JW (2003) Radiographic long bone appearance in a child administered cyclical pamidronate. Arch Dis Child 88:854PubMedCrossRef
56.
Smith SA, Norris BJ (2004) Changes in the body size of UK and US children over the past three decades. Ergonomics 47:1195–1207PubMedCrossRef
57.
Carter DR, Bouxsein ML, Marcus R (1992) New approaches for interpreting projected bone densitometry data. J Bone Miner Res 7:137–145PubMedCrossRef
58.
Molgaard C, Thomsen BL, Prentice A, Cole TJ, Michaelsen KF (1997) Whole body bone mineral content in healthy children and adolescents. Arch Dis Child 76:9–15PubMedCrossRef
59.
60.
Boyde A, Travers R, Glorieux FH, Jones SJ (1999) The mineralization density of iliac crest bone from children with osteogenesis imperfecta. Calcif Tissue Int 64:185–190PubMedCrossRef
61.
Rauch F (2006) Material matters: a mechanostat-based perspective on bone development in osteogenesis imperfecta and hypophosphatemic rickets. J Musculoskelet Neuronal Interact 6:142–146PubMed
Metadata
Title
A reference database for the Stratec XCT-2000 peripheral quantitative computed tomography (pQCT) scanner in healthy children and young adults aged 6–19 years
Authors
R. L. Ashby
K. A. Ward
S. A. Roberts
L. Edwards
M. Z. Mughal
J. E. Adams
Publication date
01-08-2009
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 8/2009
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-008-0800-2

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