Methodological aspects of short-term knemometry in the assessment of exogenous glucocorticosteroid-induced growth suppression in children

During recent years knemometry has been introduced for short-term assessment of the growth-suppressive effect of exogenous glucocorticosteroids in children. The aim of the present paper is to review methodological aspects of short-term knemometry used for this purpose. Knemometry has proven a highly accurate and reproducible method for assessment of short-term growth suppression in populations of children treated with exogenous glucocorticosteroids. Randomized, double-blind crossover and parallel designs applying consistent measurement intervals can be used. Confounding influences on the growth results from possible inter-group differences in spontaneous growth velocities are reduced in the crossover design. Glucocorticosteroid-induced knemometric growth suppression seems to reflect suppressive effects on soft tissue and bone components in the lower leg. In children treated with systemic glucocorticosteroids a shortening of the lower leg, which may be due to a reduction of the water content in the soft tissue, may confound the growth assessment. Suppressed short-term growth rates should be considered to have a poor correlation with long-term growth, though prospectively planned, controlled studies of the relation are needed in glucocorticosteroid-treated children.