Baer TG, Agarwal S, Chen S, et al. - Using high-resolution peripheral quantitative computed tomography (HR-pQCT), researchers assessed bone microarchitecture in growth hormone (GH)-deficient [GHD] boys. Fifteen control and fifteen GHD, GH naïve pre-pubertal boys were enrolled for a case-control study at a major academic center. Excluded were individuals with panhypopituitarism, chromosomal pathology, chronic steroids, or stimulant use. GHD individuals had a significantly smaller distal radius cortical perimeter compared with controls, with the difference in cortical perimeter persisting after adjusting for height z, age, lean mass, and 25-hydroxyvitamin D. There were no significant differences in volumetric bone mineral density. There were no major variations in microarchitecture, estimated strength, areal BMD, body composition, or markers of bone turnover. Analysis demonstrated significant positive associations between insulin-like growth factor 1 levels and cortical parameters. Prepubertal GHD boys had bone geometry deficits that were not evident with DXA. Larger prospective/longitudinal HR-pQCT studies are required to evaluate the nature of these deficits, the need for regular bone assessment and the timing of GH replacement to avoid or restore these deficits.