Juvenile osteoporosis
Objectives- Describe the clinical features of (idiopathic) juvenile osteoporosis
- Discuss the natural history of juvenile osteoporosis
Discussion point
- What is the role of spine bracing for children with juvenile osteoporosis?
Discussion
Idiopathic juvenile osteoporosis is an ill-understood condition that most often has and onset between ages 8 and 14. Presenting symptoms are long bone fractures, back pain, and difficulty walking. Typically, radiographs demonstrate compression of the vertebra and the metaphyses of long bones. In a recent study, the defect appeared to be secondary to osteoblast dysfunction, children with juvenile osteoporosis have a markedly decreased bone volume and low bone turnover. A previous study had concluded to the contrary. The outlook for spontaneous recovery is good, usually in 2-4 years or at skeletal maturity, but protracted disability has been reported in a small number of adults. Bracing of spinal deformity, a reasonable concept, has been recommended, but the experience is small.
References
- Bertelloni S, Baroncelli GI, Di Nero G, Saggese G. Idiopathic juvenile osteoporosis: evidence of normal osteoblast function by 1,25-dihydroxyvitamin D3 stimulation test [published erratum appears in Calcif Tissue Int 1992 Nov; 51( 5): 400]. Calcified Tissue International 1992; 51( 1): 20-3.
- Jones ET, Hensinger RN. Spinal deformity in idiopathic juvenile osteoporosis. Spine 1981; 6( 1): 1-4.
- Rauch F, Travers R, Norman ME, Taylor A, Parfitt AM, Glorieux FH. Deficient bone formation in idiopathic juvenile osteoporosis: a histomorphometric study of cancellous iliac bone. Journal of Bone & Mineral Research 2000; 15( 5): 957-63.
- Smith R. Idiopathic juvenile osteoporosis: experience of twenty-one patients. British Journal of Rheumatology 1995; 34( 1): 68-77.
- Zaleske DJ. Metabolic and endocrine abnormalities. In: Morrissy RT, Weinstein SL, editors. Pediatric Orthopaedics. Philadelphia: Lippincott-Raven; 1996. p. 137-201.
May 11-14, 2011 in Montreal, Quebec, Canada
