Bone density assessment in a tertiary paediatric centre over 13 years: Referral patterns and limitations

Area of Science:

• Paediatric Endocrinology
• Bone Metabolism
• Healthcare Access

Background:

• Bone density assessment in children is crucial for managing conditions predisposing to low bone mass.
• Understanding referral patterns is key to optimizing access to paediatric bone densitometry services.

Purpose of the Study:

• To analyze referral practices for paediatric bone densitometry at the Royal Children's Hospital (RCH) over 13 years.
• To identify referral patterns and barriers to accessing paediatric bone densitometry.

Main Methods:

• Retrospective review of 5767 bone densitometry scans performed on 3004 patients under 18 years.
• Data collected on referring unit, indication for referral, and densitometry results.
• Manual data extraction from referral cards and scanned medical records.

Main Results:

• Endocrinology was the primary referring department, followed by Adolescent Medicine, Gastroenterology, and Neurology.
• Eating disorders, steroid use, osteogenesis imperfecta, and inflammatory bowel disease were common indications.
• Lowest lumbar spine z-scores were observed in children with cerebral palsy and immobility.

Conclusions:

• Despite numerous childhood diseases increasing risk, paediatric bone densitometry remains underutilised.
• Inadequate support and subsidies hinder appropriate access to paediatric bone density testing.