Bone mineral density is directly tied to functional outcome and ability in children with osteogenesis imperfecta, Robert Huang, M.D., reported at the annual meeting of the American Academy of Orthopaedic Surgeons.
The findings lend credence to a current focus in treatment on improving bone mineral density (BMD) in children who are afflicted with osteogenesis imperfecta.
“Bisphosphonates have come to the forefront of treatment for osteogenesis imperfecta, but [we haven't known] the relationship of BMD ultimately to function,” said Dr. Huang of Houston Shriners Hospital.
Dr. Huang and his associates conducted a review of the records of 29 consecutive patients with osteogenesis imperfecta (ages 4–17) who underwent BMD assessment (mostly of the lumbar spine and wrist) using dual-energy x-ray absorptiometry (DXA). He and his coinvestigators then analyzed functional outcomes data that were collected using the Pediatric Outcomes Data Collection Instrument (PODCI).
Their analysis of scores obtained from parent PODCI forms revealed that there were significant relationships between lumbar spine BMD and upper extremity function. In addition, an analysis of scores that were obtained from the child PODCI scores (15 children were old enough to complete the child PODCI forms) revealed that there were significant relationships between wrist BMD and upper extremity function.
The investigators also found relationships between BMD and other functional domains within PODCI. “Certainly, BMD is an indicator of physical function,” Dr. Huang said.
DXA scanning is increasingly being used as a means of obtaining baseline measurements and for monitoring patients with osteogenesis imperfecta, but more “BMD data for children with osteogenesis imperfecta will be required to establish specific guidelines for the treatment of children with [the disorder],” he said.