To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: An Algorithm for Evaluating Healthy Children With Frequent Fractures for Low Bone Density: Presented at AAP URL: http://www.pslgroup.com/dg/2167AA.htm Doctor's Guide October 30, 2007
By Nora Steiner Mealy SAN FRANCISCO, CA -- October 30, 2007 -- Healthy children who present with frequent fractures should be screened for hypercalciuria, and if present, should be evaluated with dual-energy x-ray absorptiometry (DEXA), concluded a report presented here at the American Academy of Pediatrics 2007 National Conference and Exhibition (AAP). Leah M. Pike, MD, Paediatric Orthopedic Surgeon, Department of Paediatric Orthopaedic Surgery, Nemours Children's Clinic, Jacksonville, Florida, United States, presented the study on October 28. The study enrolled 68 healthy children aged between 5 and 17 years with a history of two or more fractures and 57 matched with control subjects, consisting of siblings of case subjects and children with no history of fractures. Children with high-energy injuries were excluded. "Parents of children with frequent fractures often ask if it could be a sign of low bone mineral density," said Dr. Pike. Children with low bone density are at increased risk of fractures. Common causes of low bone density include renal, endocrine, and absorption diseases. Until this study, it was unknown whether healthy children with frequent fractures also have low bone density. Children in the study were evaluated with a physical examination, height and weight measurements, DEXA scan, activity score, nutritional assessment, and biochemistry laboratory tests. Normal bone mineral density (BMD) was defined as more than 2 standard deviations (SDs) below the mean. Case subjects had BMD scores 0.4 SD lower than control subjects. The incidence of BMD SD < -2.0 was not significantly different between case subjects and controls (4.4% vs 1.8%). Case subjects with high renal calcium excretion accounted for almost all the differences in BMD scores between case and control groups. Three children had lower than normal bone mineral density levels -- two were avoiding dairy products and one had delayed puberty. The study authors concluded that hypercalciuria is associated with low BMD in children. Healthy children with frequent fractures should be evaluated with an urinary calcium-to-creatinine ratio to screen for hypercalciuria, they note. Children with hypercalciuria should undergo a DEXA scan to evaluate BMD, as should children with delayed puberty or a calcium-restricted diet. In the absence of these risk factors, healthy children with frequent fractures need not be evaluated with DEXA scanning. [Presentation title: Do Healthy Children With Frequent Fractures Require Evaluation for Low Bone Density? Abstract 305] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.