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dc.contributor.authorRosendahl, Karen
dc.contributor.authorLundestad, Anette
dc.contributor.authorBjørlykke, John Asle
dc.contributor.authorLein, Regina Küfner
dc.contributor.authorAngenete, Oskar W
dc.contributor.authorAugdal, Thomas Angell
dc.contributor.authorMüller, Lil-Sofie Ording
dc.contributor.authorJaramillo, Diego
dc.date.accessioned2020-12-09T10:36:45Z
dc.date.available2020-12-09T10:36:45Z
dc.date.issued2020-11-02
dc.description.abstract<i>Background</i> - Imaging for osteoporosis has two major aims, first, to identify the presence of low bone mass (osteopenia), and second, to quantify bone mass using semiquantitative (conventional radiography) or quantitative (densitometry) methods. In young children, densitometry is hampered by the lack of reference values, and high-quality radiographs still play a role although the evaluation of osteopenia as a marker for osteoporosis is subjective and based on personal experience. Medical experts questioned in court over child abuse, often refer to the literature and state that 20–40% loss of bone mass is warranted before osteopenia becomes evident on radiographs. In our systematic review, we aimed at identifying evidence underpinning this statement. A secondary outcome was identifying normal references for cortical thickness of the skeleton in infants born term, < 2 years of age.<p> <p><i>Methods</i> - We undertook systematic searches in Medline, Embase and Svemed+, covering 1946–2020. Unpublished material was searched in Clinical trials and International Clinical Trials Registry Platform (ICTRP). Both relevant subject headings and free text words were used for the following concepts: osteoporosis or osteopenia, radiography, children up to 6 years.<p> <p><i>Results</i> - A total 5592 publications were identified, of which none met the inclusion criteria for the primary outcome; the degree of bone loss warranted before osteopenia becomes visible radiographically. As for the secondary outcome, 21 studies were identified. None of the studies was true population based and none covered the pre-defined age range from 0–2 years. However, four studies of which three having a crossectional and one a longitudinal design, included newborns while one study included children 0–2 years.<p> <p><i>Conclusions</i> - Despite an extensive literature search, we did not find any studies supporting the assumption that a 20–40% bone loss is required before osteopenia becomes visible on radiographs. Reference values for cortical thickness were sparse. Further studies addressing this important topic are warranted.en_US
dc.identifier.citationRosendahl, Lundestad, Bjørlykke, Lein, Angenete, Augdal, Müller, Jaramillo. Revisiting the radiographic assessment of osteoporosis-Osteopenia in children 0-2 years of age. A systematic review. PLOS ONE. 2020;15:e0241635(11):1-13en_US
dc.identifier.cristinIDFRIDAID 1848909
dc.identifier.doi10.1371/journal.pone.0241635
dc.identifier.issn1932-6203
dc.identifier.urihttps://hdl.handle.net/10037/20040
dc.language.isoengen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.journalPLOS ONE
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2020 The Author(s)en_US
dc.subjectVDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710en_US
dc.subjectVDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710en_US
dc.titleRevisiting the radiographic assessment of osteoporosis-Osteopenia in children 0-2 years of age. A systematic reviewen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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