BACKGROUND: Children with cerebral palsy (CP), often nonambulatory and/or on anticonvulsants, are at increased risk for fractures. Bone mineral density (BMD) measured by the conventional techniques of dual-energy X-ray absorptiometry (DXA) often cannot be reliably or easily measured in these patients. OBJECTIVE: To find an alternative site to whole body, spine and hip that can be conveniently used to measure BMD in CP patients. MATERIALS AND METHODS: Having observed that CP patients prefer to lie on their sides, we explored measuring BMD at the distal femur in the lateral projection. A total of 92 scans were performed without sedation in 34 children and adolescents with CP, aged 4-19 years. Four femoral shaft subregions were created: two trabecular and two cortical. RESULTS: The coefficients of variation (CV %) were generally higher for opposite-side comparisons (n = 12 patients) than for same-side comparisons (n = 16 patients). For intra- and interobserver analyses, CV % were higher for cortical regions than for trabecular regions. Overall, the CV % were similar to those for hip and spine. CONCLUSION: This peripheral site in the femur should be considered as an alternative for patients with CP when whole-body, hip and spine DXA are not practical.
BACKGROUND:Children with cerebral palsy (CP), often nonambulatory and/or on anticonvulsants, are at increased risk for fractures. Bone mineral density (BMD) measured by the conventional techniques of dual-energy X-ray absorptiometry (DXA) often cannot be reliably or easily measured in these patients. OBJECTIVE: To find an alternative site to whole body, spine and hip that can be conveniently used to measure BMD in CPpatients. MATERIALS AND METHODS: Having observed that CPpatients prefer to lie on their sides, we explored measuring BMD at the distal femur in the lateral projection. A total of 92 scans were performed without sedation in 34 children and adolescents with CP, aged 4-19 years. Four femoral shaft subregions were created: two trabecular and two cortical. RESULTS: The coefficients of variation (CV %) were generally higher for opposite-side comparisons (n = 12 patients) than for same-side comparisons (n = 16 patients). For intra- and interobserver analyses, CV % were higher for cortical regions than for trabecular regions. Overall, the CV % were similar to those for hip and spine. CONCLUSION: This peripheral site in the femur should be considered as an alternative for patients with CP when whole-body, hip and spine DXA are not practical.
Authors: David R Weber; Alison Boyce; Catherine Gordon; Wolfgang Högler; Heidi H Kecskemethy; Madhusmita Misra; Diana Swolin-Eide; Peter Tebben; Leanne M Ward; Halley Wasserman; Christopher Shuhart; Babette S Zemel Journal: J Clin Densitom Date: 2019-07-10 Impact factor: 2.617
Authors: Richard C Henderson; Brent A Henderson; Heidi H Kecskemethy; Sebastian T Hidalgo; Beth Ann Nikolova; Kevin Sheridan; H Theodore Harcke; Deborah E Thorpe Journal: J Clin Densitom Date: 2014-06-03 Impact factor: 2.617
Authors: Maria Luisa Bianchi; Sanford Baim; Nick J Bishop; Catherine M Gordon; Didier B Hans; Craig B Langman; Mary B Leonard; Heidi J Kalkwarf Journal: Pediatr Nephrol Date: 2009-07-15 Impact factor: 3.714