Pediatric Reference Data for Bone Mineral Density in the Calcaneus for Healthy Children 2, 4, and 7 Years of Age by Dual-Energy X-Ray Absorptiometry and Laser

Dual-energy X-ray absorptiometry and laser (DXL) Calscan measures bone mineral density (BMD) in the calcaneus. In the present study, the DXL Calscan device has been modified for use in pediatric practice. It includes a function for measuring calcaneal height, which makes it possible to calculate volumetric bone mineral apparent density (BMAD). The aims of the present study were to evaluate the method when used in children, to create pediatric reference values in healthy Swedish 2-, 4-, and 7-yr-old children for BMD, bone mineral content (BMC), and BMAD, and to study whether these parameters were related to auxological data. The method was well tolerated by all children. Intraindividual coefficients of variation for BMC and BMD decreased with increasing age. The mean BMD was 0.17 ± 0.003 g/cm2 in 2-yr-old children, 0.22 ± 0.003 g/cm2 in 4-yr-old children, and 0.30 ± 0.005 g/cm2 in 7-yr-old children. This study provides normative data as percentile values for BMD, BMC, and BMAD in young children measured with DXL Calscan. BMD was significantly correlated with age (p < 0.001), height (p = 0.001), weight (p < 0.001), and body mass index standard deviation score (p < 0.001). Seven-year-old girls showed significantly higher BMD than boys.