Use of bone age for evaluating bone density in patients with Duchenne muscular dystrophy: a preliminary report

Al-Zougbi A, Mathews KD, Shibli-Rahhal A. Use of bone age for evaluating bone density in patients with Duchenne muscular dystrophy: A preliminary report. Muscle & nerve 2019;59:422-425

Al-Zougbi_2019_Muscle Nerve. Jan 12

A study suggesting that it would be better to use bone age as a reference for bone density instead of the actual chronological age of the DMD patient, since patients show delayed puberty and skeletal maturation compared due to corticosteroid treatment.  Indeed using bone age lead to lower estimations of bone density deficits. This study is, however, far too small, using a very heterogeneous population to draw reliable conclusions.

Abstract

INTRODUCTION: Patients with Duchenne muscular dystrophy (DMD) exhibit low bone mineral density and increased fracture risk. Because glucocorticoid therapy results in delayed puberty and short stature, it is important to account for delayed skeletal development when interpreting their bone mineral density.

METHODS: 12 glucocorticoid-treated patients with DMD were evaluated by dual x-ray absorptiometry (DXA) scans and wrist x-rays to estimate bone density and bone age, respectively. Z-scores were determined based on chronological age. Each patient was the assigned a “corrected” birth date calculated based on bone age and a bone-age-corrected z-score determined.

RESULTS: Z-scores adjusted for chronological age were lower than those adjusted for bone age.

DISCUSSION: We suggest the use of bone age as an alternative to chronological age for the analysis of bone mineral density in glucocorticoid treated-patients with DMD. Additional research is needed to determine the optimal method to predict fracture risk in this patient group. This article is protected by copyright. All rights reserved.

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