Evaluation of bone density in newborn infants by computed x-ray densitometry

Bone Mineral Density in Children From Anthropological and Clinical Sciences: A Review

Bone mineral density (BMD) is a frequent topic of discussion in the clinical literature in relation to the bone health of both adults and children. However, in archaeological and/ or anthropological studies the role of BMD is often cited as a possible factor in the poor skeletal preservation which can lead to an under-representation of juvenile skeletal remains. During skeletal development and growth throughout childhood and adolescence changes take place in both the size and shape of bones and these changes also result in the increasing of mineral content. BMD can be affected by many factors, which include, age, genetics, sexual maturation, amount of physical activity and dietary calcium. This paper aims to review the clinical and anthropological literature on BMD and discuss the numerous methods of measurement and how the availability of certain methods such as Dual-energy x-ray absorptiometry (DEXA) and quantitative computed tomography (QCT) can influence the study of bone density in archaeological skeletal collections and also the future potential for forensic anthropological studies.

Clinical-radiological features of fractures in premature infants--a review

Premature infants are more vulnerable to bone fractures than term infants for numerous reasons, directly or indirectly related to prematurity. Although the reported incidence of fractures in this vulnerable population is somewhat inconsistent, the increased risk is clear. Metabolic disorders, genetic disease, accidental trauma, and non-accidental injury can all account for fractures in premature infants, so that determining the etiology is of importance. This increased risk does not appear to continue into childhood. Thus, most of these fractures would be found in children <3 years of age, often within the first year of life. Unfortunately, this is the same age group in which the majority of non-accidental injury (NAI) cases, frequently presenting with fractures, are seen. Further confounding the diagnosis is the possibility of previously undiagnosed fractures from trauma during delivery, and fractures due to bone weakening by metabolic diseases. A multi-dimensional approach using a combination of diagnostic procedures is necessary to properly identify the location of the fractures, the bone structure and characteristics, and the history with regards to family situation and medical treatment. This paper reviews the potential factors related to fractures in premature infants and the differential diagnoses of child abuse fractures.

Increments in whole body bone mineral content associated with weight and length in pre-term and full-term infants during the first 6 months of life

BACKGROUND

The objective of the present study was to assess bone mineral content (BMC) of the whole skeleton in pre-term and full-term healthy infants and the factors influencing BMC, such as bone area, birth weight, birth length, current weight, current length, gender, and gestational age.

METHODS

Forty-eight healthy full-term infants and 34 healthy premature infants fed predominantly with intact human milk were studied. BMC was measured monthly with dual energy X-ray absorptiometry (DEXA). At the same time, length and weight were measured and registered. Pre-term infants were studied at 60-day intervals.

RESULTS

For both full-term and pre-term infants, BMC increased during the first months of life. However, the values of pre-term infants never reached the values of full-term infants, even after correcting for age and weight. For both full-term and pre-term infants, BMC was significantly correlated at the second month with birth weight (r = 0.901), birth length (r = 0.860), gestational age (r = 0.803), bone area (r = 0.960), current weight (r = 0.920), and current length (r = 0.840, p <0.001 for all correlation coefficients). Multivariate analysis revealed that bone area was the most important factor in predicting BMC.

CONCLUSIONS

Pre-term children have lower BMC than full-term children. The main factor explaining this apparent osteopenia is bone area. Pre-term children have a higher daily mineralization rate than full-term children, but this catch-up mineralization is not enough to reach BMC levels seen in full-term children.