ArticleBone2020
Intermachine differences in DXA measurements vary by skeletal site, and impact the assessment of low bone density in children.
Article in Bone, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 15 citations in OpenAlex.
- Combination of artificial intelligence and chest computed tomography to assess bone mineral density.Skeletal radiology · 2026Article
- Prevalence and predictors of low bone mineral density in pediatric inflammatory bowel disease.Journal of pediatric gastroenterology and nutrition · 2025Article
- Assessing osteopenia and osteoporosis with dual-energy x-ray absorptiometry studies in Fabry disease.Orphanet journal of rare diseases · 2025Article
- The assessment of bone health in children with juvenile idiopathic arthritis; comparison of different imaging-based methods.Pediatric rheumatology online journal · 2024Article
- Assessment and management of low bone mineral density in children with cerebral palsy.Journal of the Pediatric Orthopaedic Society of North America · 2024Article
- A cross-calibration study using a novel dual X-ray absorptiometry system for bone mineral density measurements with the European Spine Phantom.Quantitative imaging in medicine and surgery · 2023Article
- Histologic Severity of Nonalcoholic Fatty Liver Disease Associates with Reduced Bone Mineral Density in Children.Digestive diseases and sciences · 2023Article
- Reference values of bone mineral density of proximal femur for Southeast Asian children and adolescents.Archives of osteoporosis · 2022Article
- The fracture predictive ability of lumbar spine BMD and TBS as calculated based on different combinations of the lumbar spine vertebrae.Archives of osteoporosis · 2022Article
- An update on methods for assessing bone quality and health in Cystic fibrosis.Journal of clinical & translational endocrinology · 2022Article
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Authors and funding
10 authors at 8 institutions in 1 country.
Funding
Abstract
backgroundBone mineral content (BMC) and areal-bone mineral density (aBMD) measurements of the lumbar spine (LS) and whole body less head (WBLH) by dual energy X-ray absorptiometry (DXA) are recommended for bone health assessment in children. Intermachine differences were not considered previously in formulating these recommendations. METHODOLOGY: DXA measurements of the LS, WBLH, total hip, femoral neck and distal 1/3 radius from the Bone Mineral Density in Childhood Study were examined. Healthy children, ages 6 to 16 years, from five clinical centers participated. The same spine, whole body, and femur phantoms were measured on each Center's DXA machine. Percentage of individuals with low BMC or aBMD (Z-score < -1.5) was determined. Clinical center differences were evaluated by analysis of covariance adjusting for height and BMI Z-score, calcium intake, physical activity, Tanner stage and bone age. Logistic regression assessed odds of low BMC or aBMD across clinical centers.
resultsSignificant differences among Clinical Centers (p < 0.05) were evident in adjusted mean BMC and aBMD Z-scores (n = 1503) for all skeletal sites. WBLH BMC and aBMD Z-scores had the greatest range across centers (-0.13 to 0.24, and -0.17 to 0.56, respectively). The percentage of children with Z-scores less than -1.5 varied among Clinical Centers from 1.9 [95%CI 0.8, 4.5] to 8.1 [95%CI 5.7, 11.3] for WBLH BMC, 1.1 [95%CI 0.4, 3.5] to 6.3 [95%CI 3.8, 10.1] for WBLH aBMD, and from 4.4 [95%CI 2.8, 7.0] to 12.6 [95%CI 9.3, 16.9] for distal 1/3 radius aBMD. For each skeletal site except total hip aBMD and femoral neck BMC, at least one center had significantly lower odds of low bone density.
conclusionsBy design, our reference ranges capture intermachine variability. Most clinical centers don't know where their machine falls within the range of intermachine variability, and this may affect diagnosis of children evaluated for conditions that threaten bone health. Total hip scans showed the least, and whole body scans showed the most intermachine variability. Pediatric bone health assessment recommendations should recognize intermachine differences and address this important issue.
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