Radiographic vertebral morphology: a diagnostic tool in pediatric osteoporosis.
OBJECTIVE
To assess the value of spinal radiographs in determining the significance of reductions in bone mass or density in chronically ill children.


METHODS
A pediatric scoring method for assessment of osteoporotic vertebral changes, developed on the basis of radiographs of 70 healthy controls and established adult scoring methods, was subsequently used to assess 32 pediatric patients with suspected secondary osteoporosis. Radiographic findings were correlated with bone mineral density (BMD), clinical data, and biochemistry.


RESULTS
Thirty-two patients (median age 14.1 years) were included. Assessment of spinal radiographs with the developed scoring method found previously undiagnosed spinal compression deformities in 11 patients (34%) of whom 9 were asymptomatic and 8 had lumbar spine (size-corrected) BMD measurements within +/-2.0 SD of the age- and sex-specific norms. Fracture history and cumulative glucocorticoid (GC) dose did not differ between those with and without compression deformities.


CONCLUSIONS
Vertebral compression fractures can be documented in a significant number of chronically ill children and are poorly predicted by single BMD measurements and clinical history. Assessment of vertebral morphology is recommended as an additional tool in the diagnostic workup of pediatric osteoporosis.
Mäkitie
Outi
O
The Hospital for Sick Children, Department of Endocrinology, University of Toronto, ON, Canada.
Doria
Andrea S
AS
Henriques
Flavia
F
Cole
William G
WG
Compeyrot
Sandrine
S
Silverman
Earl
E
Laxer
Ronald
R
Daneman
Alan
A
Sochett
Etienne B
EB
D015502:Absorptiometry, Photon; D000293:Adolescent; D015519:Bone Density; D002117:Calcitriol / Q000097:blood; D002118:Calcium / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002908:Chronic Disease; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000000981:diagnostic imaging*; D010281:Parathyroid Hormone / Q000097:blood; D012044:Regression Analysis; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000209:etiology; D013131:Spine / Q000000981:diagnostic imaging
D005938:Glucocorticoids; D010281:Parathyroid Hormone; D002117:Calcitriol; D002118:Calcium