Study of BHI in children below 2 years with and without Osteogenesis Imperfecta

This study has a sinister background: In children below the age of two years with unexplained fractures, it may be difficult to distinguish those with low bone density due to conditions such as osteogenesis imperfecta (OI) from those who have been abused (by violence). Therefore, a new paper by Shalof and Offiah from University of Sheffield and Sheffield Children’s Hospital investigated whether bone health index standard deviation scores (BHI SDS) is sufficiently sensitive to distinguish between children with and without OI. The study included 33 radiographs of children with OI, and 89 of children with suspected abuse and not OI, i.e., normal children. The BHI SDS values of the normal children were compatible with a normal distribution with mean 0 and SD 1, showing that the BHI reference curves in BoneXpert, which were based on children born in 1955 in Paris, are still valid in a modern population. The OI children had a mean BHI SDS = –0.5 and SD around 1.