Use of quantitative ultrasound to assess bone status in children with juvenile idiopathic arthritis

Njeh, C.F., Shaw, N., Gardner-Medwin, J.M., Boivin, C.M. and Southwood, T.R. (2000) Use of quantitative ultrasound to assess bone status in children with juvenile idiopathic arthritis. Journal of Clinical Densitometry, 3(3), pp. 251-260. (doi:10.1385/JCD:3:3:251)

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Periarticular osteoporosis around inflamed joints and generalized osteoporosis have been shown to be markers of disease activity and severity in children with juvenile idiopathic arthritis (JIA). Bone mineral density (BMD) in adults can be assessed precisely by dual X-ray absorptiometry (DXA), but this technique has not been used widely in children. Quantitative ultrasound (QUS) may provide an alternative method for assessment of bone status. The aim of this pilot study was to compare QUS to DXA in assessing generalized osteoporosis in a cohort of patients with JIA. Twenty-two Caucasian children (15 females, 7 males) with JIA of duration of 19–142 (mean 71 mo) and age 7–17 yr were recruited. Total body and lumbar spine BMD and bone mineral content (BMC) were measured by DXA using standard procedures on a Lunar DPX-L scanner. QUS was performed using Myriad SoundScan 2000. Speed of sound (SOS) was measured at the right midtibia. The DXA results were compared to QUS using linear regression analysis. Spine and total body BMD measured by DXA correlated significantly with tibia SOS (spine: r = 0.57, p < 0.007; total body: r = 0.68, p < 0.001). Spine BMC was similarly related to SOS as BMD (r = 0.58, p < 0.007). Individual patient weight and height were strong predictors of BMD, but only moderate predictors of SOS. The mean spine BMD was lower in the JIA patients compared to the normal ranges (mean Z-score of -1.19). BMD Z-scores were negatively associated with duration of disease. Patients taking steroids were associated with lower Z-scores. In conclusion, SOS shows a significant correlation with BMD as measured by DXA, albeit with wide 95% confidence intervals in this small pilot study. QUS was also well tolerated and was technically easy to perform in these children. With the added advantage that it is free from radiation risk, further assessment of this potentially valuable tool for measuring bone status in children is warranted.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Gardner-Medwin, Dr Janet
Authors: Njeh, C.F., Shaw, N., Gardner-Medwin, J.M., Boivin, C.M., and Southwood, T.R.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
Journal Name:Journal of Clinical Densitometry
Published Online:08 June 2006

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