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© 2003 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 22:1337-1340 • 0278-4297

Reproducibility of Heel Ultrasound Measurement in Prepubescent Children

Lack of Influence of Ethnicity, Sex, or Body Size

Roger Martin Djoumessi Zebaze, MD, Evelyn Brooks, PhD, Matthew High, Eileen Duty, RN and Wendell Bronson, DO, FACR

Austin and Repatriation Medical Centre, The University of Melbourne, Melbourne, Victoria, Australia (R.M.D.Z.); and Missouri Western State College (E.B.), St Joseph Public School System (E.D.), and Heartland Health Arthritis and Osteoporosis Center (M.H., W.B.), St Joseph, Missouri USA.

Address correspondence and reprint requests to Wendell Bronson, DO, FACR, Heartland Health Arthritis and Osteoporosis Center, 810 Faraon, St Joseph, MO 64501 USA. E-mail: wbronson{at}stjoelive.com.

Objective. There is a growing demand for assessment of bone status in children. Among the techniques currently available, quantitative ultrasound measurement is attractive because of its lower cost, portability, and safety. However, factors influencing its reproducibility in children remain an issue. This study was designed to evaluate the effects of ethnicity, sex, and body size on the short-term reproducibility of heel ultrasound measurement in children. Methods. We studied 59 prepubescent children, 36 white (23 girls and 13 boys) and 23 black (9 girls and 14 boys), 5 to 12 years of age. On the same day, each child underwent triplicate measurement with an ultrasonometer and was repositioned after each measurement. Results. The precision error of the stiffness index expressed as a percentage of the coefficient of variation was generally good. There was no difference between ethnicity or sex. Respectively, the average values were 3.81% and 3.86% in white girls and boys and 3.64% and 3.51% in black girls and boys. Height, weight, and body mass index were not found to affect this reproducibility. Conclusions. These data support the reliability and usefulness of ultrasound for assessment of pediatric bone status.

Key Words: ethnicity • sex • heel ultrasound measurement reproducibility • prepubescent children

Abbreviations: BMI, body mass index • BUA, broadband ultrasound attenuation • CV, coefficient of variation • PE, precision error • RMS, root mean square • SI, stiffness index • SOS, speed of sound




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