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The Utility of DXA Assessment at the Forearm, Proximal Femur, and Lateral Distal Femur, and Vertebral Fracture Assessment in the Pediatric Population: The 2019 Official Pediatric Positions of the ISCD

Review article
Authors David R. Weber
Alison Boyce
Catherine Gordon
Wolfgang Hogler
Heidi H. Kecskemethy
Madhusmita Misra
Diana Swolin-Eide
Peter Tebben
Leanne M. Ward
Halley Wasserman
Christopher Shuhart
Babette S. Zemel
Published in Journal of Clinical Densitometry
Volume 22
Issue 4
Pages 567-589
ISSN 1094-6950
Publication year 2019
Published at Institute of Clinical Sciences, Department of Pediatrics
Pages 567-589
Language en
Keywords Children, DXA, Forearm, lateral distal femur, proximal femur, vertebral fracture assessment
Subject categories Pediatrics, Endocrinology


© 2019 Dual-energy X-ray absorptiometry (DXA) is widely used in the evaluation of bone fragility in children. Previous recommendations emphasized total body less head and lumbar spine DXA scans for clinical bone health assessment. However, these scan sites may not be possible or optimal for all groups of children with conditions that threaten bone health. The utility of DXA scans of the proximal femur, forearm, and radius were evaluated for adequacy of reference data, precision, ability of predict fracture, and applicability to all, or select groups of children. In addition, the strengths and limitations of vertebral fracture assessment by DXA were evaluated. The new Pediatric Positions provide guidelines on the use of these additional measures in the assessment of skeletal health in children.

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