Challenges in assessing bone health in early infancy: a narrative review of existing technologies

Area of Science:

• Pediatrics
• Radiology
• Biophysics

Background:

• Lack of established guidelines for diagnosing and managing low bone mineral density (BMD) in infants.
• Infants are susceptible to risk factors like maternal vitamin D deficiency, preterm birth, and low birth weight, necessitating bone health monitoring.
• Current BMD assessment methods (biochemical markers, DXA, QUS) have limitations in newborns and infants.

Purpose of the Study:

• To highlight the need for new methodologies for assessing bone health in infants.
• To introduce Radiofrequency Echographic Multi-Spectrometry (REMS) as a promising tool for infant BMD assessment.
• To discuss the potential of REMS for mass screening strategies in sensitive populations.

Main Methods:

• Review of current diagnostic tools for infant BMD, including biochemical markers, DXA, and QUS.
• Introduction of REMS technology, emphasizing its radiation-free nature, ease of use, cost-effectiveness, sensitivity, specificity, and reproducibility.
• Discussion of the limitations of existing methods and the advantages of REMS.

Main Results:

• REMS is identified as a potentially superior technique for screening and monitoring BMD in newborns and infants.
• REMS offers advantages over traditional methods due to its safety profile and performance characteristics.
• A significant gap exists as validated REMS reference cut-offs for pediatric populations are currently unavailable.

Conclusions:

• REMS technology presents a promising, radiation-free approach for assessing bone mineral density in infants.
• Further longitudinal studies are essential to establish REMS reference standards and develop diagnostic algorithms for pediatric bone health.
• Integrated approaches combining biochemical and instrumental data are needed for effective diagnosis and management of low BMD in infants.