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This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Kohli, M. Articles by Charron, M. PubMed Articles by Kohli, M. Articles by Charron, M.

Vertebral fracture assessment in the pediatric patient: How does lateral dual absorptiometry (DXA) compare to digital radiography?

¹ Nuclear Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada

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Objectives: Pediatric vertebral fractures are conventionally assessed with digital radiography of the thoracic and lumbar spine. In adults the lateral view obtained with dual energy absorptiometry (DXA) is recently available as a clinical tool to screen for vertebral compression fractures. The purpose of this study is to compare the sensitivity of lateral DXA and radiography for the detection of compression fractures in children.

Methods: 43 patients who had both thoracic and lumbar spine radiography and DXA within two months of each other were evaluated from April 2007 to December 2007. The upper thoracic spine was not evaluated on DXA due to poor definition. Lumbar and lower thoracic spine radiography and DXA were reviewed by physicians blinded to the clinical scenario.

Results: DXA was found to correlate well with radiography in 32 cases - 27 normal and 5 moderate to severe compression fractures of the lower thoracic and lumbar spine. In 3 of those 5 cases, DXA was interpreted as normal on initial review (after discussion between reviewers, the DXA was considered positive by consensus). In 1 case, DXA suggested a fracture not identified on the plain film. In 10 cases with mild compression fractures detected on radiography, DXA disclosed no abnormality on the lateral view.

Conclusions: This study suggests that while DXA correlates relatively well with radiography in moderate to severe compression fractures of the lower thoracic and lumbar spine, radiography was much more sensitive in detecting mild compression fractures. Larger prospective trials are needed to confirm our preliminary findings.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Kohli, M. Articles by Charron, M. PubMed Articles by Kohli, M. Articles by Charron, M.