The potential of digital X-ray radiogrammetry (DXR) in the assessment of osteopenia in children with chronic inflammatory bowel disease.
BACKGROUND
Loss of bone mass is a known complication of chronic inflammatory bowel disease (IBD) in children. The gold standard in the evaluation of bone mineral density (BMD) is dual energy X-ray absorptiometry (DXA).


OBJECTIVE
In this preliminary study we evaluated digital X-ray radiogrammetry (DXR) which estimates BMD (DXR-BMD) from hand radiographs in children with IBD.


METHODS
A total of 26 children with IBD (10 girls, 16 boys; age range 10-18 years) underwent DXR for the calculation of DXR-BMD and metacarpal index (DXR-MCI) using the Pronosco X-posure system. The results were compared with a local reference database and correlated with the results of DXA.


RESULTS
DXR-BMD was 0.36-0.56 g/cm(2) (median 0.46 g/cm(2)) in Crohn disease patients and 0.38-0.63 g/cm(2) (median 0.48 g/cm(2)) in ulcerative colitis patients. DXR-MCI was 0.29-0.49 in Crohn disease patients and 0.28-0.53 in ulcerative colitis patients. The Z-scores were reduced to <-1 SD in five Crohn disease patients and in six ulcerative colitis patients. The coefficients (r) for the correlations between DXR-BMD and DXA-BMD were 0.78 for the lumbar spine and 0.61 for the proximal femur (P<0.01), and between DXR-MCI and DXA-BMD were 0.78 for the lumbar spine and 0.51 for the proximal femur (P<0.01).


CONCLUSIONS
DXR seems to be able to estimate cortical osteopenia in children with chronic IBD. The DXR results showed a positive correlation with DXA results.
Mentzel
Hans-Joachim
HJ
Department of Pediatric Radiology, Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Bachstrasse 18, 07740, Jena, Germany. hans-joachim.mentzel@med.uni-jena.de
Blume
Joerg
J
Boettcher
Joachim
J
Lehmann
Gabriele
G
Tuchscherer
Diana
D
Pfeil
Alexander
A
Kramer
Anika
A
Malich
Ansgar
A
Kauf
Eberhard
E
Hein
Gert
G
Kaiser
Werner A
WA
D015502:Absorptiometry, Photon; D000293:Adolescent; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging* / Q000209:etiology; D002648:Child; D003093:Colitis, Ulcerative / Q000150:complications / Q000000981:diagnostic imaging*; D003424:Crohn Disease / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D011856:Radiographic Image Enhancement