Automated radiogrammetry is a feasible method for measuring bone quality and bone maturation in severely disabled
Sandra Mergler1,2, Stella A de Man3, Annemieke M Boot4
1Department of General Practice and Intellectual Disability Medicine, University Medical Centre, Erasmus MC, Rotterdam, The Netherlands. s.mergler@erasmusmc.nl.
Insights
Automated radiogrammetry can assess bone quality in children with neurological impairments. This study found significantly diminished bone quality and altered bone age in these children, highlighting the need for age-specific reference values.
Area of Science:
- Pediatric orthopedics
- Radiology
- Bone health
Background:
- Children with severe neurological impairment and intellectual disability often experience poor bone quality and fractures.
- Assessing bone health in this population is crucial for fracture prevention and management.
Purpose of the Study:
- To evaluate the feasibility of automated radiogrammetry for assessing bone quality in children with severe neurological impairment and intellectual disability.
- To determine bone quality and bone age in this cohort, considering potential alterations in skeletal maturation.
Main Methods:
- Hand radiographs from 95 children (mean age 11.4 years) were analyzed using BoneXpert software.
- Automated radiogrammetry was employed to measure bone quality (pediatric bone index) and bone age.
Main Results:
- Automated radiogrammetry successfully provided a pediatric bone index in 63.2% of children.
- Children exhibited significantly lower bone quality (mean SDS -1.85) compared to healthy peers, with nearly 50% showing severely diminished bone quality.
- Bone age deviated from chronological age by more than one year in 64% of children, predominantly indicating delayed maturation.
Conclusions:
- Automated radiogrammetry is a feasible method for assessing bone quality in children with disabilities, excluding those with severe contractures.
- Children with severe neurological impairment and intellectual disability demonstrate substantially reduced bone quality.
- Given frequent deviations in bone maturation, using bone-age-related reference values is recommended for accurate assessment.
Background:
Children with severe neurological impairment and intellectual disability are prone to low bone quality and fractures.
Objective:
We studied the feasibility of automated radiogrammetry in assessing bone quality in this specific group of children. We measured outcome of bone quality and, because these children tend to have altered skeletal maturation, we also studied bone age.
Materials And Methods:
We used hand radiographs obtained in 95 children (mean age 11.4 years) presenting at outpatient paediatric clinics. We used BoneXpert software to determine bone quality, expressed as paediatric bone index and bone age.
Results:
Regarding feasibility, we successfully obtained a paediatric bone index in 60 children (63.2%). The results on bone quality showed a mean paediatric bone index standard deviation score of -1.85, significantly lower than that of healthy peers (P < 0.0001). Almost 50% of the children had severely diminished bone quality. In 64% of the children bone age diverged more than 1 year from chronological age. This mostly concerned delayed bone maturation.
Conclusion:
Automated radiogrammetry is feasible for evaluating bone quality in children who have disabilities but not severe contractures. Bone quality in these children is severely diminished. Because bone maturation frequently deviated from chronological age, we recommend comparison to bone-age-related reference values.
