Bone quality assessment by quantitative ultrasound of proximal phalanxes of the hand in healthy subjects aged 3-21 years

Bone quality by quantitative ultrasound was assessed in 1083 (587 males) he althy white subjects aged 3-21 y. Amplitude-dependent speed of sound (AD-So S) through the distal end of the first phalanx diaphysis of the last four f ingers of the hand was measured by an ultrasound device (DBM Sonic 1200, IG EA, Carpi, Italy). Mean AD-SoS values increased progressively from 3 to 21 y (males, 1845.9-2119.1 m/s, p < 0.0001; females, 1842.3-2098.8 m/s, p < 0. 0001). They did not differ (p = NS) between sexes up to age 11, but females showed higher (p < 0.05 - p < 0.0001) AD-SoS values than males in age grou ps 12, 13, and 14 y. There was no difference (p = NS) of AD-SoS values betw een sexes in pubertal stages 1, 2, and 5, but females had higher mean AD-So S values than males in stages 3 (p < 0.01) and 4 (p < 0.001). Independent p redictors of AD-SoS were weight, body mass index, pubertal stage, and mean width of fingers in males, and age, pubertal stage, and mean width of finge rs in females (p < 0.01 -p < 0.0001). However, 7.8% in males and 3.6% in fe males of the increment of AD-SoS values can be related to the finger anatom y alone. AD-SoS values probably reflect the architectural organization of g rowing bone or changes in bone elasticity. Increased bone density and size may be additional factors influencing AD-SoS. Measurement of AD-SoS at the hand phalanxes may be a simple, noninvasive, and radiation-free technique t o assess bone quality in children.