Advances in Bone Assessment Methods in Children

KEY POINTS
Advances in bone assessment techniques, such as low-radiation quantitative computed
tomography, provide the ability to measure size-independent cortical and trabecular volumetric bone mineral density, bone and muscle geometry, and estimates of bone strength.

These have been useful in understanding bone development, disease mechanisms, and
responses to bone-active interventions.

Numerous skeletal sites can now be measured, which overcomes challenges in patient
positioning and surgical hardware placement, and which allows the clinician to select
the most logical part of the skeleton to monitor in response to bone health threats or
interventions.

Dual energy x-ray absorptiometry–based vertebral fracture assessment holds promise for
more widespread vertebral fracture screening in high-risk populations, such as children
with primary osteoporosis and glucocorticoid-treated diseases.

Bone marrow fat is an endocrine-active tissue that merits further study of its role in bone
strength and disease.