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Updated: May 14, 2026
A Novel Application of Musculoskeletal Ultrasound Imaging
Published on: September 17, 2013
Ultrasound velocity through the tibia is not affected by prolonged inhaled steroid therapy in children
Elie Picard1, Menucha Wilk, Francis B Mimouni
1Pediatric Pulmonary Unit, Shaare Zedek Medical Center, The Hebrew University, School of Medicine, Jerusalem, Israel. picard@szmc.org.il
Insights
Inhaled corticosteroids (ICS) did not negatively impact bone speed of sound (SOS) in children with mild-to-moderate asthma. Prolonged ICS therapy showed no adverse effects on bone health in this pediatric cohort.
Area of Science:
- Pediatric Pulmonology
- Pediatric Endocrinology
- Bone Densitometry
Background:
- Asthma is a common chronic respiratory disease in children.
- Inhaled corticosteroids (ICS) are the mainstay of treatment for persistent asthma.
- Concerns exist regarding potential long-term effects of ICS on bone health in pediatric populations.
Purpose of the Study:
- To investigate the association between inhaled corticosteroid (ICS) use and bone speed of sound (SOS) in children with mild-to-moderate asthma.
- To evaluate the impact of asthma duration and ICS therapy duration on bone health parameters.
Main Methods:
- A prospective, cross-sectional cohort study involving 85 children with mild-to-moderate asthma.
- Data collected included clinical and demographic factors, asthma severity, treatment duration, sports participation, and dairy intake.
- Tibial bone speed of sound (SOS) was measured using quantitative ultrasound (Sunlight Omnisense 7000S).
Main Results:
- While SOS Z-scores were negatively correlated with asthma duration and ICS duration in univariate analysis, these did not remain significant in the final multivariate model.
- Gender, asthma duration, and BMI were the only significant predictors of SOS Z-score in the multiple regression analysis.
- The final model explained 17.52% of the variance in SOS Z-score, indicating other factors also influence bone health.
Conclusions:
- Prolonged inhaled corticosteroid therapy does not appear to have a deleterious effect on bone speed of sound in children with mild-to-moderate persistent asthma.
- Bone health in asthmatic children is influenced by factors such as gender, asthma duration, and BMI.
- Further research may be warranted to explore other contributing factors to bone health in this population.
Aim:
To evaluate in a prospective, cross-sectional cohort study the impact of inhaled corticosteroids (ICS) on bone speed of sound (SOS) in asthmatic children.
Methods:
Children with mild-to-moderate asthma from a pulmonary clinic were assessed over a 2-month period. We recorded clinical and demographic data related to asthma severity, its treatment, participation in sports and dairy intake. Tibial SOS was measured using the Sunlight Omnisense 7000S quantitative ultrasound bone sonometer.
Results:
Eighty-five mild-to-moderate asthmatic children were studied. Age range was 1.4-17 years (71.7% boys). Average disease duration was approximately 5 years, and the average cumulative duration of ICS therapy was approximately 1.5 years. Average SOS Z-score was slightly negative and varied between -3.5 and +1.9 SD. In univariate analysis, SOS Z-score was negatively correlated with asthma duration (R(2) = 5.7%, p = 0.028) and ICS duration (R(2) = 4.9%, p = 0.042). In backward stepwise multiple regression, where SOS Z-score was the dependent variable, the only variables that remained significant in the final analysis were gender (p = 0.015), asthma duration (p = 0.003) and BMI (p = 0.048) (R(2) for the model 17.52% p = 0.01).
Conclusion:
Prolonged inhaled steroid therapy appears to have no deleterious effect upon SOS in children with mild-to-moderate persistent asthma.
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