Update on bone density measurements and their interpretation in children and adolescents

Best Pract Res Clin Endocrinol Metab. 2018 Aug;32(4):477-498. doi: 10.1016/j.beem.2018.06.002. Epub 2018 Jun 18.


Following the increased awareness about the central role of the pediatric age in building bone for life, clinicians face more than ever the necessity of assessing bone health in pediatric subjects at risk for early bone mass derangements or in healthy children, in order to optimize their bone mass accrual and prevent osteoporosis. Although the diagnosis of osteoporosis is not made solely upon bone mineral density measurements during growth, such determination can be very useful in the follow-up of pediatric patients with primary and secondary osteoporosis. The ideal instrument would give information on the mineral content and density of the bone, and on its architecture. It should be able to perform the measurements on the skeletal sites where fractures are more frequent, and it should be minimally invasive, accurate, precise and rapid. Unfortunately, none of the techniques currently utilized fulfills all requirements. In the present review, we focus on the pediatric use of dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QCT), peripheral QCT (pQCT), and magnetic resonance imaging (MRI), highlighting advantages and limits for their use and providing indications for bone densitometry interpretation and of vertebral fractures diagnosis in pediatric subjects.

Keywords: bone mineral content (BMC); bone mineral density (BMD); dual–energy X-ray absorptiometry (DXA); magnetic resonance imaging (MRI); peripheral QCT (pQCT); quantitative computed tomography (QCT).

Publication types

  • Review

MeSH terms

  • Absorptiometry, Photon / methods*
  • Adolescent
  • Bone Density / physiology*
  • Bone and Bones
  • Child
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Osteoporosis / diagnostic imaging*
  • Tomography, X-Ray Computed / methods*