Pediatric dual-energy X-ray absorptiometry in clinical practice: What the clinicians need to know. Issue 105 (August 2018) - Messina, Carmelo
Highlights: DXA is the gold standard technique for bone mass measurement in pediatric patients. Common pediatric DXA examination sites are lumbar spine and "total body less head". Proximal femur scan is usually not indicated in pediatric patients. Bone mineral apparent density (BMAD) is the most accurate DXA value in pediatric patients. Pediatric DXA scan should be performed only when the results can influence patient's management. Abstract: The importance of childhood and adolescence for bone development and mineral accrual is increasingly accepted, leading to a need of suitable methods for monitoring bone health even in pediatric setting. Among the several different imaging methods available for clinical measurement of bone mineral density (BMD) in children, dual-energy X-ray absorptiometry (DXA) is the most widely available and commonly used due to its reproducibility, negligible radiation dose and reliable pediatric reference data. Nevertheless, DXA in children has some technical specific features that should be known by those physicians who interpret and report this examination. We provide recommendations for optimal DXA scan reporting in pediatric setting, including indications, skeletal sites to be examined, parameters to be measured, timing of follow-up BMD measurements. Adequate report and analysis of DXA examinations are essential to prevent over- and underdiagnosis of bone mineral impairment in pediatric patients. In conclusion, a complete and exhaustive DXA report in children and adolescents is mandatory for an accurate diagnosis and a precise monitoring of pediatric bone status.