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Pediatr Radiol. 1998 Apr;28(4):241-6.

Lateral femoral scan: an alternative method for assessing bone mineral density in children with cerebral palsy.

Author information

1
duPont Hospital for Children, Department of Medical Imaging, P. O. Box 269, Wilmington, DE 19899, USA.

Abstract

BACKGROUND:

Children with cerebral palsy (CP), often nonambulatory and/or on anticonvulsants, are at increased risk for fractures. Bone mineral density (BMD) measured by the conventional techniques of dual-energy X-ray absorptiometry (DXA) often cannot be reliably or easily measured in these patients.

OBJECTIVE:

To find an alternative site to whole body, spine and hip that can be conveniently used to measure BMD in CP patients.

MATERIALS AND METHODS:

Having observed that CP patients prefer to lie on their sides, we explored measuring BMD at the distal femur in the lateral projection. A total of 92 scans were performed without sedation in 34 children and adolescents with CP, aged 4-19 years. Four femoral shaft subregions were created: two trabecular and two cortical.

RESULTS:

The coefficients of variation (CV %) were generally higher for opposite-side comparisons (n = 12 patients) than for same-side comparisons (n = 16 patients). For intra- and interobserver analyses, CV % were higher for cortical regions than for trabecular regions. Overall, the CV % were similar to those for hip and spine.

CONCLUSION:

This peripheral site in the femur should be considered as an alternative for patients with CP when whole-body, hip and spine DXA are not practical.

PMID:
9545479
DOI:
10.1007/s002470050341
[Indexed for MEDLINE]

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