Computed axial tomographic scanning of the thigh: an alternative method of nutritional assessment in pediatrics

In this study we compared the findings of computed axial tomographic (CT) scanning of the thigh with the findings of arm anthropometry and urinary creatinine determinations to assess nutrition in children with inflammatory bowel disease receiving total parenteral nutrition. All 14 children received our standard solution for total parenteral nutrition as well as prednisone and sulfasalazine (Azulfidine) therapy. All patients were assessed by arm anthropometry, 24-hour urine collections for creatinine clearance, and CT scanning of the thigh during total parenteral nutrition. Arm muscle and fat area were estimated by anthropometry, and those in the thigh were estimated by CT scanning. Our results show the total muscle area from the CT scan can predict muscle mass calculated from the urinary creatinine excretion rates. In addition, there is a close correlation between the thigh muscle area as measured by CT scanning and the muscle area calculated from urinary creatinine excretion rates. In addition, the comparison of thigh muscle area and thigh fat area to the midarm muscle area and midarm fat area, respectively, showed that the thigh is a better predictor of muscle than fat in the midarm. We conclude that the total thigh muscle area is a better predictor of muscle mass as compared to the midarm muscle area. In addition, the CT scan cut at the level of the thigh in children and adolescents with inflammatory bowel disease can provide valuable information about the thigh compartment and analyses of different cross-sectional areas of the thigh.