Osteoporosis in children and adolescents: when to suspect and how to diagnose it

被引:49
作者
Ciancia, Silvia [1 ]
van Rijn, Rick R. [2 ]
Hoegler, Wolfgang [3 ]
Appelman-Dijkstra, Natasha M. [4 ]
Boot, Annemieke M. [5 ]
Sas, Theo C. J. [1 ,6 ]
Renes, Judith S. [1 ]
机构
[1] Erasmus MC, Sophia Childrens Hosp, Dept Pediat, Subdiv Endocrinol, Rotterdam, Netherlands
[2] Univ Amsterdam, Dept Radiol & Nucl Med, Amsterdam UMC, Amsterdam, Netherlands
[3] Johannes Kepler Univ Linz, Dept Paediat & Adolescent Med, Linz, Austria
[4] Leiden Univ, Ctr Bone Qual, Dept Internal Med, Subdiv Endocrinol,Med Ctr, Leiden, Netherlands
[5] Univ Groningen, Univ Med Ctr Groningen, Beatrix Childrens Hosp, Dept Pediat,Subdiv Endocrinol, Groningen, Netherlands
[6] Ctr Pediat & Adult Diabet Care & Res, Rotterdam, Netherlands
关键词
Osteoporosis; Primary osteoporosis; Secondary osteoporosis; Pediatrics; Bone health; DXA; BONE-MINERAL DENSITY; X-RAY ABSORPTIOMETRY; QUANTITATIVE COMPUTED-TOMOGRAPHY; OSTEOGENESIS IMPERFECTA; VERTEBRAL FRACTURES; RADIOGRAMMETRY; EPIDEMIOLOGY; HEALTH; GROWTH; RISK;
D O I
10.1007/s00431-022-04455-2
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Early recognition of osteoporosis in children and adolescents is important in order to establish an appropriate diagnosis of the underlying condition and to initiate treatment if necessary. In this review, we present the diagnostic work-up, and its pitfalls, of pediatric patients suspected of osteoporosis including a careful collection of the medical and personal history, a complete physical examination, biochemical data, molecular genetics, and imaging techniques. The most recent and relevant literature has been reviewed to offer a broad overview on the topic. Genetic and acquired pediatric bone disorders are relatively common and cause substantial morbidity. In recent years, there has been significant progress in the understanding of the genetic and molecular mechanistic basis of bone fragility and in the identification of acquired causes of osteoporosis in children. Specifically, drugs that can negatively impact bone health (e.g. steroids) and immobilization related to acute and chronic diseases (e.g. Duchenne muscular dystrophy) represent major risk factors for the development of secondary osteoporosis and therefore an indication to screen for bone mineral density and vertebral fractures. Long-term studies in children chronically treated with steroids have resulted in the development of systematic approaches to diagnose and manage pediatric osteoporosis. Conclusions: Osteoporosis in children requires consultation with and/or referral to a pediatric bone specialist. This is particularly relevant since children possess the unique ability for spontaneous and medication-assisted recovery, including reshaping of vertebral fractures. As such, pediatricians have an opportunity to improve bone mass accrual and musculoskeletal health in osteoporotic children.
引用
收藏
页码:2549 / 2561
页数:13
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