Peripheral Bone Status In Children With Asthma Evaluated By Digital X-Ray Radiogrammetry

Objective: Loss of bone mass is a known possible complication in children with asthma. We evaluated the applicability of digital X-ray radiogrammetry (DXR), which estimates cortical bone mineral density (DXR-BMD) for quantification of cortical demineralisation in children with asthma. Study design: 17 children (9f, 8m; mean age 11.3 years) underwent DXR measurements for calculation of DXR-BMD and metacarpal index (DXR-MCI) using the Pronosco X-posure system (V.2, Sectra Pronosco A/S, Vedbaek, Denmark ) on the base of radiographs of the non-dominant left hand. The results were compared to a regional age and gender matched reference data base and correlated to asthma severity and use of inhaled corticosteroids. Results: DXR-BMD was between 0.34 and 0.57g/cm2 (median 0.41; SD 0.06) in asthmatic children compared to a range from 0.39 to 0.59g/cm2 (median 0.41; SD 0.06) in the reference population. DXR-MCI was between 0.27 and 0.58 in asthmatics compared to a range from 0.33 to 0.46 in controls. The Z-scores for DXR-BMD were reduced for more than -1 SD in 4 asthmatics (23.5%) and the Z-Score for DXR-MCI was reduced in 6 patients (35.3%). The correlation between DXR-BMD and the dose of inhaled glucocorticoids for at least 6 months and asthma severity was significant (p<0.05). Conclusion: Digital X-ray radiogrammetry performed on radiograms on the non-dominant left hand may be sensitive to assess osteopenia in children with asthma.

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