Pediatric Patient Information

In providing this resource, please note this website is not providing medical advice.  The sole purpose of this section is to provide a general overview of bone densitometry for patients and individuals who wish to improve their understanding of this technology: what it is, how it’s done and what the results mean. You should discuss your individual needs with your doctor or other healthcare provider. All medical decisions should be made by your doctor in consultation with you and any other relevant parties.

What is Osteoporosis?

Osteoporosis is a condition of bone fragility that may be caused by low bone density or other bone abnormalities that affect bone strength.

Can children have osteoporosis?

Yes, children can have osteoporosis. It may be related to chronic medical conditions or medication use. Some diseases have a direct effect on bone – these are called primary bone disorders. Other diseases have indirect effects on bone related to inflammation, malabsorption, immobility, hormonal disturbances, or severe anemia. Some medications such as steroid medications or chemotherapy agents can also affect bone.

How do I know if my child has osteoporosis?

Osteoporosis is defined as having either 1) a fracture in the spine or 2) the combination of having a low bone density test result and two long bone fractures for children ages 10 and younger or three long bone fractures for ages up to 19 years. (View to the 2019 ISCD Pediatric Official Positions) Your child’s doctor will consider all of the relevant factors when deciding if your child has osteoporosis.

What is a bone densitometry test?

A bone density test is a non-surgical, painless examination that uses low dose x-rays to measure the density of bones. There are different kinds of bone density tests. The one that is recommended for children is called dual energy x-ray absorptiometry, or DXA. DXA tests may take pictures of the entire body or parts of the body such as the spine or hip.
The same equipment is used to measure bone density in children and adults. For children, DXA scans of the spine and whole body are recommended sites to measure. The whole body scan provides information on the amount of lean and fat tissue in addition to bone. For some diseases, this information may help clinicians interpret the bone density results. For some diseases, DXA measurements of the arm or leg might also be done in children.

What are the risks involved?

DXA tests involve a very low amount of radiation exposure – less than the amount of radiation to which you are exposed during an airplane flight. So, the risks are considered extremely low.

Should my child have a bone density test?

Most healthy children do not need a bone density test. There are certain medical conditions where a bone density test is recommended. You should discuss with your doctor whether your child needs a bone density test.

What should my child expect at the time of a bone density test?

Your child will need to change into clothes that do not have any metal snaps, zippers or buttons. The child’s height and weight may be measured.  They will be asked to lie down on the DXA table, and the technologist will help position them. Each individual DXA scan takes approximately 1-3 minutes. Your child will need to lie still during the test. Nothing will touch your child during the test and they will not feel anything painful; however, they will feel the table move during each scan.  Some facilities allow parents to accompany the child during the procedure.

When should a bone density test be repeated?

For some medical conditions or treatments, a bone density test may be repeated periodically in order to monitor progress. Your doctor will tell you when a bone density test should be repeated.

Where should I take my child for a bone density test?

This depends on where you live. For some individuals there may be many options, while for others there may be few or none. Bone density testing is widely available in many countries and performed in many settings including hospitals, other healthcare imaging facilities, doctors’ offices, screening health fairs, pharmacies and sometimes as part of a mobile health unit. It is estimated that there are about 18,000 DXA machines in the United States. Some estimates show the number of DXA machines outside the United States to be about 18,000. Although travel, cost and convenience are important things to consider when making this decision, there are also technical issues to take into account so you get the best value for your money.

It is important that the operator of DXA machine is well trained in its proper use and that the person interpreting the results is knowledgeable in the field of bone densitometry. It is best if they are trained in its use in children. Obtaining and interpreting a pediatric DXA scan requires special expertise. Since March 2009, the ISCD has offered an annual Pediatric Bone Densitometry Course for clinicians and technologists.

One indicator that the technologist and clinician have received appropriate training in bone densitometry is to ask if they are ISCD Certified. You can also search the online ISCD Certification Registry to find a certified technologist (CDT or CBDT) or certified clinician (CCD) in your area. The ISCD Certification Registry lists participating certified individuals – Certified Clinical Densitometrist® (CCD), Certified Densitometry Technologist® (CDT) and Certified Bone Densitometry Technologist™ (CBDT). Individuals may choose not to be displayed in this listing. Evaluation of the credentials, qualifications and competence of a physician or technologist is the responsibility of the person referencing the registry. 

What are some resources for related information?

Check out the following Web sites, some of which are geared to kids:
Kids and Their Bones: A Guide for Parents
Healthy Bones Matter

Author Information

Dr. Babette Zemel, PhD

Dr. Catherine M. Gordon, MD, CCD