title: Reference values for digital X-ray radiogrammetry parameters in children and adolescents in comparison to estimates in patients with distal radius fractures.
abstract: The first objective of this study was to determine normative digital X-ray radiogrammetry (DXR) values, based on original digital images, in a pediatric population (aged 6-18 years). The second aim was to compare these reference data with patients suffering from distal radius fractures, whereas both cohorts originated from the same geographical region and were evaluated using the same technical parameters as well as inclusion and exclusion criteria. DXR-BMD and DXR-MCI of the metacarpal bones II-IV were assessed on standardized digital hand radiographs, without printing or scanning procedures. DXR parameters were estimated separately by gender and among six age groups; values in the fracture group were compared to age- and gender-matched normative data using Student's t tests and Z scores. In the reference cohort (150 boys, 138 girls), gender differences were found in bone mineral density (DXR-BMD), with higher values for girls from 11 to 14 years and for boys from 15 to 18 years (p < 0.05). Girls had higher normative metacarpal index (DXR-MCI) values than boys, with significant differences at 11-14 years (p < 0.05). In the case-control investigation, the fracture group (95 boys, 69 girls) presented lower DXR-BMD at 15-18 years in boys and 13-16 years in girls vs. the reference cohort (p < 0.05); DXR-MCI was lower at 11-18 years in boys and 11-16 years in girls (p < 0.05). Mean Z scores in the fracture group for DXR-BMD were -0.42 (boys) and -0.46 (girls), and for DXR-MCI were -0.51 (boys) and -0.53 (girls). These findings indicate that the fully digital DXR technique can be accurately applied in pediatric populations ≥ 6 years of age. The lower DXR-BMD and DXR-MCI values in the fracture group suggest promising early identification of individuals with increased fracture risk, without the need for additional radiation exposure, enabling the initiation of prevention strategies to possibly reduce the incidence of osteoporosis later in life.
authors: Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353, Berlin, Germany. diane.renz@charite.de.
authors: Diane M
authors: DM
authors: Renz
authors: Institute of Diagnostic Radiology, Suedharz Clinic Nordhausen, Dr. Robert-Koch-Str. 39, 99734, Nordhausen, Germany.
authors: Ansgar
authors: A
authors: Malich
authors: Institute of Diagnostic Radiology, Suedharz Clinic Nordhausen, Dr. Robert-Koch-Str. 39, 99734, Nordhausen, Germany.
authors: Andreas
authors: A
authors: Ulrich
authors: Department of Internal Medicine III, Jena University Hospital, Friedrich-Schiller-University, Erlanger Allee 101, 07740, Jena, Germany.
authors: Alexander
authors: A
authors: Pfeil
authors: Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich-Schiller-University, Erlanger Allee 101, 07740, Jena, Germany.
authors: Hans-Joachim
authors: HJ
authors: Mentzel
authors: Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353, Berlin, Germany.
authors: Florian
authors: F
authors: Streitparth
authors: Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353, Berlin, Germany.
authors: Martin H
authors: MH
authors: Maurer
authors: Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich-Schiller-University, Erlanger Allee 101, 07740, Jena, Germany.
authors: Ulf K
authors: UK
authors: Teichgräber
authors: Institute of Diagnostic and Interventional Radiology, SRH Clinic Gera, Str. des Friedens 122, 07548, Gera, Germany.
authors: Joachim
authors: J
authors: Böttcher
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D015519:Bone Density / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D011856:Radiographic Image Enhancement; D011885:Radius Fractures / Q000000981:diagnostic imaging*; D012016:Reference Values; D014965:X-Rays
keywords: Bone mineral density; Childhood; Digital X-ray radiogrammetry; Distal radius fracture; Metacarpal index