Hogler et al used a 4-step decision tree to evaluate the bone status of a pediatric patient. The autors are from the Children's Hospital at Westmead and University Hospital Innsbruck.
Patient selection: pediatric patient
Exam: DEXA (dual energy X-ray absorptiometry)
Measurements:
(1) lean tissue mass (LTM)
(2) bone mineral density (BMD)
(3) bone mineral content (BMC)
(4) height in cm
(5) age
Derived ratios:
(1) bone mineral density to age ratio
(2) height to age ratio
(3) lean tissue mass to height ratio
(4) bone mineral content to lean total mass ratio
(BMD) / (age)
(height) / (age)
(LTM)/(height)
(BMC)/LTM)
Assessment
normal
low or normal
NA
NA
normal
normal
high
normal
normal
normal
normal
high
normal
low
primary BD
normal
high
low
normal
secondary BD
normal
high
low
low
mixed BD
low
low
NA
NA
likely normal
low
normal or high
normal
normal
normal
low
normal or high
normal
low
primary BD
low
normal or high
low
normal
secondary BD
low
normal or hig
low
low
mixed BD
where:
• BD = bone defect
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