Pediatric Radiology

, Volume 28, Issue 4, pp 241–246 | Cite as

Lateral femoral scan: an alternative method for assessing bone mineral density in children with cerebral palsy

  • H. T. Harcke
  • Arlene Taylor
  • Steven Bachrach
  • Freeman Miller
  • Richard C. Henderson

Abstract

Background. Children with cerebral palsy (CP), often nonambulatory and/or on anticonvulsants, are at increased risk for fractures. Bone mineral density (BMD) measured by the conventional techniques of dual-energy X-ray absorptiometry (DXA) often cannot be reliably or easily measured in these patients. Objective. To find an alternative site to whole body, spine and hip that can be conveniently used to measure BMD in CP patients. Materials and methods. Having observed that CP patients prefer to lie on their sides, we explored measuring BMD at the distal femur in the lateral projection. A total of 92 scans were performed without sedation in 34 children and adolescents with CP, aged 4–19 years. Four femoral shaft subregions were created: two trabecular and two cortical. Results. The coefficients of variation (CV %) were generally higher for opposite-side comparisons (n = 12 patients) than for same-side comparisons (n = 16 patients). For intra- and interobserver analyses, CV % were higher for cortical regions than for trabecular regions. Overall, the CV % were similar to those for hip and spine. Conclusion. This peripheral site in the femur should be considered as an alternative for patients with CP when whole-body, hip and spine DXA are not practical.

Keywords

Bone Mineral Density Bone Mineral Cerebral Palsy Cortical Region Conventional Technique 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • H. T. Harcke
    • 1
  • Arlene Taylor
    • 2
  • Steven Bachrach
    • 3
  • Freeman Miller
    • 4
  • Richard C. Henderson
    • 5
  1. 1.duPont Hospital for Children, Department of Medical Imaging, P. O. Box 269, Wilmington, DE 19899, USAUS
  2. 2.Department of Research, duPont Hospital for Children, Wilmington, Delaware, USAUS
  3. 3.Department of Pediatrics, duPont Hospital for Children, Wilmington, Delaware, USAUS
  4. 4.Department of Orthopaedics, duPont Hospital for Children, Wilmington, Delaware, USAUS
  5. 5.Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USAUS

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