Bone densitometry using computed tomography.Part II: increased trabecular bone density in children with chronic renal failure

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Abstract
The method of .gamma.-ray computed tomography (CT) bone densitometry provides selective determination of trabecular bone density (TBD), the relative amount of compact bone (bone density, BD) and the total absorption (TA) within a bone cross section. Seven of 9 children with chronic renal failure (CRF), and selected based only on their serum creatinine value (> 5 mg/100 ml), had increased TBD values above the normal range; the other bone mineral parameters were normal. Radiographic signs of secondary hyperparathyroidism (subperiosteal erosions, cysts) were reported in the 5 patients with the highest TBD values; the subjective diagnosis of osteosclerosis reported in 3 of these 5 and in 1 other patient correlated less well with the TBD increases. This is the 1st report of an objective, non-invasive documentation of the radiological finding of osteosclerosis in CRF. It explains why methods for bone mineral measurements used previously, e.g., a photon absorptiometry which provides only a parameter equivalent to TA, failed to reveal increases in bone mineral content in renal osteodystrophy even when signs of osteosclerosis were present. .gamma.-Ray CT did in objectively documenting the degree of osteosclerosis and its location.