Calcaneal ultrasound imaging in healthy children and adolescents: Relationof the ultrasound parameters BUA and SOS to age, body weight, height, footdimensions and pubertal stage
Jpw. Van Den Bergh et al., Calcaneal ultrasound imaging in healthy children and adolescents: Relationof the ultrasound parameters BUA and SOS to age, body weight, height, footdimensions and pubertal stage, OSTEOPOR IN, 11(11), 2000, pp. 967-976
We investigated the quantitative ultrasound (QUS) parameters broadband ultr
asound attenuation (BUA) and speed of sound (SOS) measured in the posterior
part of the calcaneus at the region of interest (ROI) with the lowest atte
nuation, using an ultrasound imaging device (UBIS 3000) in 491 healthy Cauc
asian children and adolescents (262 girls, 229 boys) between 6 and 21 years
old. The relation of age, body weight, height, foot dimensions and puberta
l stage to BUA and SOS was assessed. BUA increased nonlinearly with age in
boys and girls, r(2) being 0.44 (p<0.001) and 0.57 (p<0.001), respectively.
SOS increased linearly with age in girls (r(2) = 0.04, p<0.001). There was
no significant increase in SOS in boys (r(2) = 0.01, p>0.05). Heel width w
as significantly con-elated with BUA (r = 0.20, p<0.005 in boys; r = 0.27,
p<0.05 in girls) and with SOS (r = -0.19, p<0.005 in boys; r = -0.08, p<0.0
5 in girls). After downward adjustment of the ROI size according to foot le
ngth quartiles, significantly lower BUA and SOS values were found compared
with those with the standard ROI size of 14 mm. After correction for heel w
idth and adjustment of the ROI size based on foot length, BUA and SOS were
significantly associated with age in boys (r(2) = 0.36, p<0.001 and 0.06, p
<0.05) and in girls (r(2) = 0.53 and 0.06, both p<0.001). Tanner stage was
significantly correlated with BUA (u = 0.62,p<0.001 in boys; r = 0.73, p<0.
001 in girls) but not with SOS. BUA but not SOS increased significantly wit
h the number of years since menarche (p<0.001). In a multiple stepwise regr
ession analysis in boys, age, weight and foot length were independent predi
ctors for BUA, and age and foot length for SOS. In girls, age and weight we
re independent predictors for BUA and age was the only independent predicto
r for SOS. After correction for age, pubertal stages and heel width were no
longer determinants for QUS parameters in either boys or girls. In conclus
ion, BUA increased significantly with age in both sexes. SOS increased with
age in both boys and girls, but the increase was small and not statistical
ly significant in boys. SOS, as measured with the UBIS 3000 device, may the
refore not be appropriate to assess skeletal status in healthy children. Wh
ether SOS and BUA are affected in children with skeletal disorders has yet
to be determined. Tn boys, age, weight and foot length were independent pre
dictors for BUA and age and foot length for SOS. In girls, age and weight w
ere independent predictors for BUA and age was the only independent predict
or for SOS. In our opinion, children with small feet should be measured wit
h a smaller ROI diameter than those with larger feet.