“Bad to the Bone”

Article Outline

• Copyright

Regular readers of The Journal cannot have missed the explosion of interest in bone mineralization studies in children with various chronic disorders. Our understanding of this topic has deepened, and it is recognized that the different modalities employed in the measurement of bone density (DEXA, qualitative CT, and speed of sound [SOS]) do not measure exactly the same thing; each has its advantages and disadvantages, depending upon the situation.

A nice example of this is found in a study by DiVasta et al in Boston in this issue of The Journal. These workers examined a cohort of teenagers with anorexia nervosa, a condition known to be associated with abnormalities in bone mineralization. The short version of their conclusions is that SOS is not the appropriate modality for this population. The reason for this is not clear, but may relate to the effect of changes in other tissue compartments (e.g. fat) in the measurement.