{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T10:51:43Z","timestamp":1793875903938,"version":"4.7.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2002,6,1]],"date-time":"2002-06-01T00:00:00Z","timestamp":1022889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2002,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Bone densitometric data often are difficult to interpret in children and adolescents because of large inter- and intraindividual variations in bone size. Here, we propose a functional approach to bone densitometry that addresses two questions: Is bone strength normally adapted to the largest physiological loads, that is, muscle force? Is muscle force adequate for body size? To implement this approach, forearm muscle cross-sectional area (CSA) and bone mineral content (BMC) of the radial diaphysis were measured in 349 healthy subjects from 6 to 19 years of age (183 girls), using peripheral quantitative computed tomography (pQCT). Reference data were established for height-dependent muscle CSA and for the variation with age in the BMC\/muscle CSA ratio. These reference data were used to evaluate results from three pediatric patient groups: children who had sustained multiple fractures without adequate trauma (n = 11), children with preterminal chronic renal failure (n = 11), and renal transplant recipients (n = 15). In all three groups mean height, muscle CSA, and BMC were low for age, but muscle CSA was normal for height. In the multiple fracture group and in renal transplant recipients the BMC\/muscle CSA ratio was decreased (p &amp;lt; 0.05), suggesting that bone strength was not adapted adequately to muscle force. In contrast, chronic renal failure patients had a normal BMC\/muscle CSA ratio, suggesting that their musculoskeletal system was adapted normally to their (decreased) body size. This functional approach to pediatric bone densitometric data should be adaptable to a variety of densitometric techniques.<\/jats:p>","DOI":"10.1359\/jbmr.2002.17.6.1095","type":"journal-article","created":{"date-parts":[[2006,4,26]],"date-time":"2006-04-26T21:01:19Z","timestamp":1146085279000},"page":"1095-1101","source":"Crossref","is-referenced-by-count":208,"title":["Bone Mineral Content per Muscle Cross-Sectional Area as an Index of the Functional Muscle-Bone Unit"],"prefix":"10.1093","volume":"17","author":[{"given":"Eckhard","family":"Schoenau","sequence":"first","affiliation":[{"name":"Children's Hospital, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina Maria","family":"Neu","sequence":"additional","affiliation":[{"name":"Children's Hospital, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bodo","family":"Beck","sequence":"additional","affiliation":[{"name":"Children's Hospital, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedrich","family":"Manz","sequence":"additional","affiliation":[{"name":"Research Institute of Child Nutrition, Dortmund, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Rauch","sequence":"additional","affiliation":[{"name":"Children's Hospital, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2009,10,27]]},"reference":[{"key":"2024013019084376100_bib1","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1002\/jbmr.5650110602","article-title":"Noninvasive assessment of bone mineral and structure: State of the art","volume":"11","author":"Genant","year":"1996","journal-title":"J Bone Miner Res"},{"key":"2024013019084376100_bib2","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/S0720-048X(97)00093-4","article-title":"Bone density in children: A review of the available techniques and indications","volume":"26","author":"Gilsanz","year":"1998","journal-title":"Eur J Radiol"},{"key":"2024013019084376100_bib3","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1359\/jbmr.1997.12.4.509","article-title":"From density to structure: Growing up and growing old on the surfaces of bone","volume":"12","author":"Seeman","year":"1997","journal-title":"J Bone Miner Res"},{"key":"2024013019084376100_bib4","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1172\/JCI8184","article-title":"The assembly of the adult skeleton during growth and maturation: Implications for senile osteoporosis","volume":"104","author":"Riggs","year":"1999","journal-title":"J Clin Invest"},{"key":"2024013019084376100_bib5","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1359\/jbmr.2001.16.4.597","article-title":"Changes in bone density during childhood and adolescence\u2014an approach based on bone's biological organization","volume":"16","author":"Rauch","year":"2001","journal-title":"J Bone Miner Res"},{"key":"2024013019084376100_bib6","first-page":"1414","article-title":"Growth in bone mass and size\u2014-are racial and gender differences in bone mineral density more apparent than real?","volume":"83","author":"Seeman","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"2024013019084376100_bib7","first-page":"3\u20131","volume-title":"Mechanics","author":"Benedek","year":"1973"},{"key":"2024013019084376100_bib8","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1359\/jbmr.1997.12.10.1547","article-title":"Muscle strength, bone mass, and age-related bone loss","volume":"12","author":"Burr","year":"1997","journal-title":"J Bone Miner Res"},{"key":"2024013019084376100_bib9","first-page":"1","volume-title":"Forces in Joints","author":"Martin","year":"1998"},{"key":"2024013019084376100_bib10","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1152\/jappl.1955.7.6.593","article-title":"A dimensional analysis of physical performance and growth in boys","volume":"7","author":"Asmussen","year":"1955","journal-title":"J Appl Physiol"},{"key":"2024013019084376100_bib11","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1080\/03014469000000962","article-title":"A cross-sectional survey of upper and lower limb strength in boys and girls during childhood and adolescence","volume":"17","author":"Parker","year":"1990","journal-title":"Ann Hum Biol"},{"key":"2024013019084376100_bib12","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1080\/030144699282976","article-title":"Hormonal factors in the development of differences in strength between boys and girls during adolescence: A longitudinal study","volume":"26","author":"Round","year":"1999","journal-title":"Ann Hum Biol"},{"key":"2024013019084376100_bib13","first-page":"191","volume-title":"Paediatric Osteology. 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