Related Experiment Video
Updated: Jan 28, 2026
Outer-Boundary Assisted Segmentation and Quantification of Trabecular Bones by an Imagej Plugin
Published on: March 14, 2018
Bone age as a correction factor for the analysis of trabecular bone score (TBS) in children
Miguel Angel Guagnelli1, Renaud Winzenrieth2, Desiree Lopez-Gonzalez1
1Clinical Epidemiology Unit, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
Abstract:
Trabecular bone score (TBS) is a tool to improve evaluation of DXA scans, barely used in children. We proposed to evaluate TBS with bone age (BA) compared to chronological age (CA). In girls, TBS value using BA is constant until age 8, and in boys until age 10, and then starts to increase steadily. This data may help widen TBS use in pediatric populations.
Introduction:
Trabecular bone score (TBS) is a software-based tool for the analysis of DXA images to assess bone microarchitecture in the lumbar region. It is used widely in adults to improve evaluation of fracture risk, yet it has been rarely studied in children and no normal curves have been developed for pediatrics. The purpose of this study was to evaluate bone (skeletal) age compared to chronological age to determine which is better in the pediatric population since both bone age (BA) and trabecular density are equally susceptible to change in response to similar factors.
Methods:
Total body, lumbar region, and non-dominant hand scans were obtained with an iDXA device in all participants. DXA scans of lumbar region for TBS analysis and AP images of non-dominant hand-for-BA were obtained for 565 children (269 female) aged 4to 19.
Results:
Simple correlation was calculated and r2 values for TBS and chronological age were obtained by linear regression, with low correlations (0.36 for boys and 0.38 for girls), and then we created Loess curves to show the change for consecutive ages. In girls, the curve forms a U shape with a nadir point at approximately age 10. We then replaced chronological age with BA, and significant change was seen in the girls' curve, where a turning point is seen at age 8. In boys, a similar trend shows a turning point at age 10. Finally, BA-corrected TBS curves were constructed using LMS, obtaining curves with percentiles.
Conclusions:
The use of BA in the analysis and interpretation of TBS may help widen its use in pediatric populations by enabling the appearance of normative data, but more information is needed to confirm this finding.
Related Concept Videos
01:20Power Factor Correction
01:55Bone Structure
01:40Bone Remodeling
01:27Compact Bone
Compact bone, also called cortical bone, is the denser, stronger of the two types of bone tissue. It is found under the periosteum and in the diaphyses of long bones, where it provides support and protection. The microscopic structural unit of compact bone is called an osteon, or haversian system. Each osteon is composed of concentric rings of calcified...
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:12The Hyoid Bone