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Pediatric dual-energy X-ray absorptiometry: interpretation and clinical and research application

Korean Journal of Pediatrics 2010;53(3):286-293.
Published online March 15, 2010.
Pediatric dual-energy X-ray absorptiometry: interpretation and clinical and research application
Jung Sub Lim
Department of Pediatrics, Korean Cancer Center Hospital
Pediatric dual-energy X-ray absorptiometry: interpretation and clinical and research application
임중섭
Department of Pediatrics, Korean Cancer Center Hospital
Correspondence: 
Jung Sub Lim, Email: limjs@kcch.re.kr
Received: 14 January 2010   • Accepted: 18 February 2010
Abstract
Peak bone mass is established predominately during childhood and adolescence. It is an important determinant of future resistance to osteoporosis and fractures to gain bone mass during growth. The issue of low bone density in children and adolescents has recently attracted much attention and the use of pediatric dual-energy X-ray absorptiometry (DXA) is increasing. The process of interpretation of pediatric DXA results is different from that of adults because normal bone mineral density (BMD) of children varies by age, body size, pubertal stage, skeletal maturation, sex, and ethnicity. Thus, an appropriate normal BMD Z-score reference value with Z-score should be used to detect and manage low BMD. Z-scores below -2.0 are generally considered a low BMD to pediatrician even though diagnoses of osteoporosis in children and adolescents are usually only made in the presence of at least one fragility fracture. This article will review the basic knowledge and practical guidelines on pediatric DXA based on the International Society for Clinical Densitometry (ISCD) Pediatric Official Positions. Also discussed are the characteristics of normal Korean children and adolescents with respect to BMD development. The objective of this review is to help pediatricians to understand when DXA will be useful and how to interpret pediatric DXA reports in the clinical practice for management of children with the potential to develop osteoporosis in adulthood.
Key Words: Dual-energy X-ray absorptiometry (DXA), Osteoporosis, Low bone mineral density, Fracture, Children and Adolescence


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