Problems of bone analysis in childhood and adolescence

The monitoring of bone metabolism and skeletal development during childhood and adolescence is becoming increasingly important in the prevention of osteoporosis. This is especially important in patients with chronic disorders. The predominant changes in the skeletal system during growth occur as geometric adaptation processes which lead to an increase in bone mass and bone strength. These changes can be measured with linear absorption methods (single-photon absorptiometry, dual-photon absorptiometry, dual-energy X-ray absorptiometry), computed tomographic procedures (peripheral quantitative computed tomography, quantitative computed tomography), and sonographic procedures. The aim of this review is to explain the problems of interpretation of the investigations due to growth-dependent changes. Almost all methods and their parameters, such as bone density, spongiosa density, cortical density, ultrasound transmission velocity, etc., are influenced, in varying degree, by growth-dependent skeletal changes.