, Volume 36, Issue 5, pp 415-420
Date: 28 Feb 2006

The potential of digital X-ray radiogrammetry (DXR) in the assessment of osteopenia in children with chronic inflammatory bowel disease

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Loss of bone mass is a known complication of chronic inflammatory bowel disease (IBD) in children. The gold standard in the evaluation of bone mineral density (BMD) is dual energy X-ray absorptiometry (DXA).


In this preliminary study we evaluated digital X-ray radiogrammetry (DXR) which estimates BMD (DXR-BMD) from hand radiographs in children with IBD.

Materials and methods

A total of 26 children with IBD (10 girls, 16 boys; age range 10–18 years) underwent DXR for the calculation of DXR-BMD and metacarpal index (DXR-MCI) using the Pronosco X-posure system. The results were compared with a local reference database and correlated with the results of DXA.


DXR-BMD was 0.36–0.56 g/cm2 (median 0.46 g/cm2) in Crohn disease patients and 0.38–0.63 g/cm2 (median 0.48 g/cm2) in ulcerative colitis patients. DXR-MCI was 0.29–0.49 in Crohn disease patients and 0.28–0.53 in ulcerative colitis patients. The Z-scores were reduced to <−1 SD in five Crohn disease patients and in six ulcerative colitis patients. The coefficients (r) for the correlations between DXR-BMD and DXA-BMD were 0.78 for the lumbar spine and 0.61 for the proximal femur (P<0.01), and between DXR-MCI and DXA-BMD were 0.78 for the lumbar spine and 0.51 for the proximal femur (P<0.01).


DXR seems to be able to estimate cortical osteopenia in children with chronic IBD. The DXR results showed a positive correlation with DXA results.