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Objective: To assess the value of spinal radiographs in determining the signi ficance of reductions in bone mass or density in chronically ill children. Study design: A pediatric scoring method for assessment of osteoporotic vertebral cha nges, developed on the basis of radiographs of 70 healthy controls and establish ed adult scoring methods, was subsequently used to assess 32 pediatric patients with suspected secondary osteoporosis. Radiographic findings were correlated wit h bone mineral density (BMD), clinical data, and biochemistry. Results: Thirty- two patients (median age 14.1 years) were included. Assessment of spinal radiog raphs with the developed scoring method found pre viously undiagnosed spinal compression deformities in 11 patients (34% ) of whom 9 were asymptomatic and 8 had lumbar spine (size- corrected) BMD measureme nts within ± 2.0 SD of the age- and sex- specific norms. Fracture history and cumulative glucocorticoid (GC)- dose did not differ between those with and wit hout compression deformities. Conclusions: Vertebral compression fractures can b e documented in a significant number of chronically ill children and are poorly predicted by single BMD measurements and clinical history. Assessment of vertebr al morphology is recommended as an additional tool in the diagnostic workup of p ediatric osteoporosis.
Objective: To assess the value of spinal radiographs in determining the signi ficance of reductions in bone mass or density in chronically ill children. Study design: A pediatric scoring method for assessment of osteoporotic vertebral changes, developed on the basis of radiographs of 70 healthy controls and establish ed adult scoring methods, was subsequently used to assess 32 pediatric patients with suspected secondary osteoporosis. years) were included. Assessment of spinal radiog raphs with the developed scoring method found previously undiagnosed spinal compression deformities in 11 patients (34%) of whom 9 were asymptomatic and 8 had lumbar spine (size- corrected) BMD measureme nts within ± 2.0 SD of the age- and sex-specific norms. Fracture history and cumulative glucocorticoid (GC) - dose did not differ between those with and wit hout compression deformities. Conclusions: Vertebral compression fractures can be documented in a significant number of chronically ill children and are poorly predicted by single BMD measurements and clinical history. Assessment of verte al morph is recommended as an additional tool in the diagnostic work of p ediatric osteoporosis