ArticleEuropean radiology2017
Diagnostic accuracy of DXA compared to conventional spine radiographs for the detection of vertebral fractures in children.
Article in European radiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Effects of intermittent corticosteroids on scoliosis, bone density, and vertebral fractures in duchenne muscular dystrophy.Journal of neuromuscular diseases · 2026Article
- Medical Management for Fracture Prevention in Children with Osteogenesis Imperfecta.Calcified tissue international · 2024Review
- Bone health: Quality versus quantity.Journal of the Pediatric Orthopaedic Society of North America · 2024Article
- Decreasing Radiation Exposure in the Treatment of Pediatric Long Bone Fractures Using a DXA Scan: A Proof of Concept.Journal of the Pediatric Orthopaedic Society of North America · 2023Article
- Understanding entrance-air-kerma as a quality-control metric for dual-energy x-ray absorptiometry.Journal of applied clinical medical physics · 2022Article
- Current and emerging artificial intelligence applications for pediatric musculoskeletal radiology.Pediatric radiology · 2022Review
- Factors influencing peak bone mass gain.Frontiers of medicine · 2021Review
- Association between indicators of systemic inflammation biomarkers during puberty with breast density and onset of menarche.Breast cancer research : BCR · 2020Article
- Expert panel consensus recommendations for diagnosis and treatment of secondary osteoporosis in children.Pediatric rheumatology online journal · 2020Article
- Are semi-automated software program designed for adults accurate for the identification of vertebral fractures in children?European radiology · 2019Article
- Diagnosis of osteoporotic vertebral fractures in children.Pediatric radiology · 2019Review
- Inverse association between estrogen receptor-α DNA methylation and breast composition in adolescent Chilean girls.Clinical epigenetics · 2018Article
- The Utility of DXA Assessment at the Forearm, Proximal Femur, and Lateral Distal Femur, and Vertebral Fracture Assessment in the Pediatric Population: 2019 ISCD Official Position.Journal of clinical densitometry : the official journal of the International Society for Clinical DensitometryReview
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11 authors.
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Abstract
objectivesIn children, radiography is performed to diagnose vertebral fractures and dual energy x-ray absorptiometry (DXA) to assess bone density. In adults, DXA assesses both. We aimed to establish whether DXA can replace spine radiographs in assessment of paediatric vertebral fractures.
methodsProspectively, lateral spine radiographs and lateral spine DXA of 250 children performed on the same day were independently scored by three radiologists using the simplified algorithm-based qualitative technique and blinded to results of the other modality. Consensus radiograph read and second read of 100 random images were performed. Diagnostic accuracy, inter/intraobserver and intermodality agreements, patient/carer experience and radiation dose were assessed.
resultsAverage sensitivity and specificity (95 % confidence interval) in diagnosing one or more vertebral fractures requiring treatment was 70 % (58-82 %) and 97 % (94-100 %) respectively for DXA and 74 % (55-93 %) and 96 % (95-98 %) for radiographs. Fleiss' kappa for interobserver and average kappa for intraobserver reliability were 0.371 and 0.631 respectively for DXA and 0.418 and 0.621 for radiographs. Average effective dose was 41.9 μSv for DXA and 232.7 μSv for radiographs. Image quality was similar.
conclusionGiven comparable image quality and non-inferior diagnostic accuracy, lateral spine DXA should replace conventional radiographs for assessment of vertebral fractures in children. KEY POINTS: • Vertebral fracture diagnostic accuracy of lateral spine DXA is non-inferior to radiographs. • The rate of unreadable vertebrae for DXA is lower than for radiographs. • Effective dose of DXA is significantly lower than radiographs. • Children prefer DXA to radiographs. • Given the above, DXA should replace radiographs for paediatric vertebral fracture assessment.
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