title: The potential of digital X-ray radiogrammetry (DXR) in the assessment of osteopenia in children with chronic inflammatory bowel disease.
abstract: 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.
authors.affiliation: 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
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Mentzel
authors.forename: Joerg
authors.initials: J
authors.lastname: Blume
authors.forename: Joachim
authors.initials: J
authors.lastname: Boettcher
authors.forename: Gabriele
authors.initials: G
authors.lastname: Lehmann
authors.forename: Diana
authors.initials: D
authors.lastname: Tuchscherer
authors.forename: Alexander
authors.initials: A
authors.lastname: Pfeil
authors.forename: Anika
authors.initials: A
authors.lastname: Kramer
authors.forename: Ansgar
authors.initials: A
authors.lastname: Malich
authors.forename: Eberhard
authors.initials: E
authors.lastname: Kauf
authors.forename: Gert
authors.initials: G
authors.lastname: Hein
authors.forename: Werner A
authors.initials: WA
authors.lastname: Kaiser
mesh_terms: 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