title: Can ultrasound be used to estimate bone mineral density in children with growth problems?
abstract: OBJECTIVE
  To assess predictability of bone mineral density (BMD) of the lumbar spine (LS) determined by dual-energy x-ray absorptiometry (DXA) using by ultrasound speed of sound of the right and left radii (SOS-R and SOS-L) in patients with growth problems.
  
  
  METHODS
  Ultrasound and DXA were compared in patients with advanced, normal and delayed bone ages assessed by Greulich and Pyle (GP) and Tanner and Whitehouse (TW3) methods.
  
  
  RESULTS
  There was a strong correlation (r), of raw scores, between SOS-R and SOS-L, r = 0.81, p = 0.000 and their respective Z-scores, r = 0.78, p = 0.000. Z-score correlations were poor between SOS-R or SOS-L and LS-BMD. Sensitivity, specificity, positive and negative predictive values of SOS-R and Z-scores for predicting normal (>-1 to <1) and low (<-1) LS-BMD were poor. For high (>1) LS-BMD, Z-scores were 22%, 93%, 29% and 90%, respectively, for SOS-R and for SOS-L, 25%, 89%, 20% and 91%. For very low (<-2) LS-BMD, SOS-R and SOS-L were the same, respectively, 29%, 91%, 40% and 86%.
  
  
  CONCLUSIONS
  Ultrasound of the radius is a poor predictor of radiologically assessed BMD at the LS, especially with delayed bone age.
authors.affiliation: Medstar Georgetown University Hospital, Washington, DC 20007, USA. khalid.m.khan@medstar.net
authors.forename: Khalid M
authors.initials: KM
authors.lastname: Khan
authors.forename: Kyriakie
authors.initials: K
authors.lastname: Sarafoglou
authors.forename: Arif
authors.initials: A
authors.lastname: Somani
authors.forename: Brigitte
authors.initials: B
authors.lastname: Frohnert
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Miller
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000293:Adolescent; D000367:Age Factors; D015519:Bone Density / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006130:Growth Disorders / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*
keywords: Delayed bone age; Dual-energy x-ray absorptiometry; Growth; Radial ultrasound