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Case report
Distortion of dual energy X-ray images by faecal masses in a child with type 1 diabetes
  1. Nikhil Shah1,
  2. Veena Ekbote1,
  3. Vaman Khadilkar1,2 and
  4. Anuradha Khadilkar1,2
  1. 1Department of Growth and Pediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India
  2. 2Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
  1. Correspondence to Dr Anuradha Khadilkar; anuradhavkhadilkar{at}


Dual energy X-ray absorptiometry (DXA) scanning is the most common investigating modality used to assess bone mineral density (BMD). Conditions causing tissue calcification and artefacts such as metallic objects may mislead the results of the DXA scan. We present here a case of a child with diabetes where the DXA images were distorted by faecal lumps, leading to falsely elevated BMD and an error in interpretation of the DXA scans. Our case suggests that DXA software may not, at times, differentiate between bone and other high-attenuating material within the regions of interest. Thus, DXA images should also be visually examined and verified with the numeric data before report preparation in these patients.

  • calcium and bone
  • diabetes
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  • Contributors All authors played a role in management of the patient, the conception, development, planning, execution, analysis and/or writing of the manuscript and that they all agree and accept responsibility for the contents of the manuscript submitted to BMJ case reports.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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