title: Lateral femoral scan: an alternative method for assessing bone mineral density in children with cerebral palsy.
abstract: BACKGROUND
  Children with cerebral palsy (CP), often nonambulatory and/or on anticonvulsants, are at increased risk for fractures. Bone mineral density (BMD) measured by the conventional techniques of dual-energy X-ray absorptiometry (DXA) often cannot be reliably or easily measured in these patients.
  
  
  OBJECTIVE
  To find an alternative site to whole body, spine and hip that can be conveniently used to measure BMD in CP patients.
  
  
  METHODS
  Having observed that CP patients prefer to lie on their sides, we explored measuring BMD at the distal femur in the lateral projection. A total of 92 scans were performed without sedation in 34 children and adolescents with CP, aged 4-19 years. Four femoral shaft subregions were created: two trabecular and two cortical.
  
  
  RESULTS
  The coefficients of variation (CV %) were generally higher for opposite-side comparisons (n = 12 patients) than for same-side comparisons (n = 16 patients). For intra- and interobserver analyses, CV % were higher for cortical regions than for trabecular regions. Overall, the CV % were similar to those for hip and spine.
  
  
  CONCLUSIONS
  This peripheral site in the femur should be considered as an alternative for patients with CP when whole-body, hip and spine DXA are not practical.
authors.affiliation: duPont Hospital for Children, Department of Medical Imaging, P. O. Box 269, Wilmington, DE 19899, USA.
authors.forename: H T
authors.initials: HT
authors.lastname: Harcke
authors.forename: A
authors.initials: A
authors.lastname: Taylor
authors.forename: S
authors.initials: S
authors.lastname: Bachrach
authors.forename: F
authors.initials: F
authors.lastname: Miller
authors.forename: R C
authors.initials: RC
authors.lastname: Henderson
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000293:Adolescent; D000328:Adult; D015519:Bone Density; D002547:Cerebral Palsy / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005269:Femur / Q000000981:diagnostic imaging*; D006801:Humans; D015588:Observer Variation; D015203:Reproducibility of Results