Bone Health Program | Overview
The Bone Health Program at Boston Children's Hospital has been evaluating patients since 2000. We are a team of specialists (physicians, nurses, technologists, and administrative staff) with expertise in treating children and adolescents who have or are at risk for low bone density and fractures.
The Bone Health Program evaluates common and rare pediatric bone health conditions such as:
- fibrous dysplasia
- hypophosphatemic rickets
- idiopathic juvenile osteoporosis
- low bone density
- multiple fractures
- osteogenesis imperfecta
- vitamin D deficiency
- vitamin D resistance
Low bone density may also occur due to secondary medical conditions such as:
- anorexia nervosa
- inflammatory bowel disease
- parenteral nutrition
- muscular dystrophy
- long-term steroid use
- cerebral palsy
- cystic fibrosis
At Boston Children's Hospital, the physicians in the Bone Health Program are collectively board-certified in pediatric and adult endocrinology, genetics, adolescent medicine, and clinical densitometry. We are committed to help parents protect their children from low bone density. We understand that children and adolescents with low bone density have a wide range of needs, and we strive to provide patient and family-focused, empathetic, and compassionate care.
As part of a comprehensive bone health evaluation, your physician may request a bone density test.
Dual-Energy X-Ray Absorptiometry (DXA)
We evaluate bone density with DXA, the gold standard in bone density measurement. DXA is a safe and painless test performed in a private, child-friendly room. Two x-ray beams, each with different levels of energy, are directed at your child's bones. The amount of energy absorbed by the bones tells us the bone density.
Peripheral Quantitative Computed Tomography (pQCT)
QCT is another way to measure bone density, usually in an extremity such as the forearm or lower leg. QCT is also able to evaluate the geometry and strength of bones. Currently, pQCT is used for research purposes only.
- Body composition: The division of soft tissue into fat and lean tissue, based on the patient's R-value. Body composition is sometimes referred to as tissue quantitation.
- Bone density: The ratio of bone mass to volume, indicating bone compactness. Bone density increases rapidly through adolescence, more slowly until age 35 and then plateaus and declines. Bone density is measured most frequently in the spine, hip, wrist, forearm and/or heel for the detection and diagnosis of osteoporosis.
- Bone mass: The amount of mineral in a bone. Although this is different from bone density, the terms are often used interchangeably.
- Bone mineral density (BMD): The quantity calculated by dividing the measured bone mineral content by the measured bone area in a densitometry study. The bone mineral density carries units of gram per square centimeter and is most often compared to reference population values.
- Osteoporosis: A skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture. Bone strength reflects the integration of two main features: bone density and bone quality. In children, osteoporosis is defined by both a low bone density measurement and evidence of skeletal fragility. (Rauch F, Plotkin H, DiMeglio L, Engelbert RH, Henderson RC, Munns C, Wenkert D, and Zeitler P (2008) Fracture prediction and the definition of osteoporosis in children and adolescents: ISCD 2007 Pediatric Official Positions. J Clin Densitometry 11:22-28
- Peak bone mass: A concept that bone mass has a maximal level given optimal conditions. Peak bone mass is believed to be controlled by genetic factors (age, sex and body size) and significantly impacted by environmental factors (nutrition, exercise and general health). The concept of peak bone mass is important to the study of bone disease in that if an individual achieves maximal (peak) bone mass, they may reduce the risk of serious bone loss.
The Endocrinology Division is pleased to announce that our call center for scheduling your appointments will now be open from 7 a.m. to 8 p.m. Monday to Friday. Please call to make an appointment with one of our specialists at 617-355-7476.