Assessing Bone Microstructure at the Distal Radius in Children and Adolescents Using HR-pQCT: A Methodological Pilot Study

We examined the use of high-resolution peripheral quantitative computed tomography (HR-pQCT [XtremeCT; Scanco Medical, Switzerland]) to assess bone microstructure at the distal radius in growing children and adolescents. We examined forearm radiographs from 37 children (age 8-14 yr) to locate the position of the ulnar and radial growth plates. We used HR-pQCT to assess bone microstructure in a region of interest (ROT) at the distal radius that excluded the growth plate (as determined from the radiographs) in all children (n = 328; 9-21 yr old). From radiographs, we determined that a ROT in the distal radius at 7% of bone length excluded the radial growth plate in 100% of participants. We present bone microstructure data at the distal radius in children and adolescents. From the HR-pQCT scans, we observed active growth plates in 80 males (aged 9.5-20.7 yr) and 92 females (aged 9.5-20.2 yr). The ulnar plate was visible in 9 male and 17 female participants (aged 11.2 +/- 1.9 yr). The HR-pQCT scan required 3 min with a relatively low radiation dose (< 3 mu Sv). Images from the radial ROT were free of artifacts and outlined cortical and trabecular bone microstructure. There is currently no standard method for these measures; therefore, these findings provide insight for investigators using HR-pQCT for studies of growing children.