Abstract

The International Society for Clinical Densitometry periodically holds Position Development Conferences (PDCs) for the purpose of establishing standards and guidelines for the assessment of skeletal health, including nomenclature, indications, acquisition, analysis, quality control, interpretation, and reporting of bone density tests. Topics are selected for consideration according to criteria that include clinical relevancy, uncertainty in the application of medical evidence to clinical practice, and the likelihood of the expert panel to reach a consensus agreement. The first Pediatric PDC was June 20 to 21, 2007 in Montreal, Quebec, Canada. Topics included fracture prediction and definition of osteoporosis in children; dual-energy x-ray absorptiometry (DXA) assessment in children with chronic disease that may affect the skeleton; DXA interpretation and reporting in children and adolescents; and the use of peripheral quantitative computed tomography in children and adolescents. This report describes the methodology and presents the results of this recent PDC.

Key Points

* The first Pediatric Position Development Conference was held in Montreal, Quebec in June 2007.

* The diagnosis of osteoporosis in children and adolescents should not be made on the basis of densitometric criteria alone, but requires both a clinically significant fracture history and low bone mass.

* Low bone mineral content (BMC) or bone mineral density (BMD) is defined as a BMC or areal BMD Z-score that is less than or equal to −2.0, adjusted for age, gender and body size, as appropriate.

* Therapeutic interventions in children and adolescents should not be instituted on the basis of a single dual energy x-ray absorptiometry measurement.

* Pediatric reference data are not sufficient for the clinical use of peripheral quantitative computed tomography for fracture prediction or diagnosis of low bone mass in children or adolescents at this time.