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Precision of bone density and micro-architectural properties at the distal radius and tibia in children: an HR-pQCT study

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Abstract

Summary

Precision errors need to be known when monitoring bone micro-architecture in children with HR-pQCT. Precision errors for trabecular bone micro-architecture ranged from 1 to 8% when using the standard evaluation at the radius and tibia. Precision errors for cortical bone micro-architecture ranged from 1 to 11% when using the advanced cortical evaluation.

Introduction

Our objective was to define HR-pQCT precision errors (CV%RMS) and least significant changes (LSCs) at the distal radius and tibia in children using the standard evaluation and the advanced cortical evaluation.

Methods

We scanned the distal radius (7% of ulnar length) and tibia (8% of tibia length) of 32 children (age range 8–13; mean age 11.3; SD 1.6 years) twice (1 week apart) using HR-pQCT (XtremeCT1). We calculated root-mean-squared coefficients of variation (CV%RMS) to define precision errors and LSC to identify differences required to detect change.

Results

Precision errors ranged between 1–8 and 1–5% for trabecular bone outcomes (obtained with standard evaluation) and between 1.5–11 and 0.5–6% for cortical bone outcomes (obtained with advanced cortical evaluation) at the distal radius and tibia, respectively. Related LSCs ranged between 3–21 and 3–14% for trabecular bone outcomes and between 4–30 and 2–16% for cortical bone outcomes at the distal radius and tibia, respectively.

Conclusions

HR-pQCT precision errors were between 1 and 8% (LSC 3–21%) for trabecular bone outcomes and 1 and 11% (LSC 2–30%) for cortical bone outcomes at the radius and tibia in children. Cortical bone outcomes obtained using the advanced cortical evaluation appeared to have lower precision errors than cortical outcomes derived using the standard evaluation. These findings, combined with better-defined cortical bone contours with advanced cortical evaluation, indicate that metrics from advanced cortical evaluation should be utilized when monitoring cortical bone properties in children.

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Acknowledgements

We would like to thank all our participants for their altruism and volunteering for the study. CE Kawalilak acknowledges the Saskatchewan Health and Research Foundation (SHRF) and the Canadian Institute for Health Research (CIHR) for her post-doctoral fellowship funding. This work was supported in part by grants from CIHR Regional Partnership Program New Investigator Award (SK) and University of Saskatchewan CIHR Bridge funding.

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Authors and Affiliations

  1. Department of Mechanical Engineering, College of Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada

    C. E. Kawalilak, A. T. Bunyamin & J. D. Johnston

  2. College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7N 5B2, Canada

    K. M. Björkman & S. A. Kontulainen

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  1. C. E. Kawalilak
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  2. A. T. Bunyamin
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  5. S. A. Kontulainen
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Corresponding author

Correspondence to S. A. Kontulainen.

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Parents provided consent to study participation and children provided their assent prior to the study. This study was approved by the University of Saskatchewan Biomedical Research Ethics Board.

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Kawalilak, C.E., Bunyamin, A.T., Björkman, K.M. et al. Precision of bone density and micro-architectural properties at the distal radius and tibia in children: an HR-pQCT study. Osteoporos Int 28, 3189–3197 (2017). https://doi.org/10.1007/s00198-017-4185-y

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  • DOI: https://doi.org/10.1007/s00198-017-4185-y

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