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Seeing Osteogenesis Imperfecta in What Looks Like Child Abuse

Seeing Osteogenesis Imperfecta in What Looks Like Child Abuse

FEATURED SEARCH:  osteogenesis imperfecta

A false accusation of child abuse can cause great pain, but it's impossible to distinguish fractures caused by osteogenesis imperfecta (OI) from those caused by child abuse. To date, only 5 studies have tried to solve this problem.  A systematic review by authors from Childrens Hospital of Philadelphia describes the diseases that may be mistaken for child abuse, and says that such misdiagnosis is often due to "heterogeneity" in the history or examination. (Click the link at the bottom of the abstract for access to full text.)

RESULT: Unexplained fractures: Child abuse or bone disease? A systematic review
Clinical Orthopaedics and Related Research (PubMed) | Mar 1, 2011 (FREE FULL TEXT)

This recent review coauthored by two Mayo Clinic pediatricians and an orthopaedic surgery resident is intended to help primary care doctors learn to recognize OI, both because early diagnosis is crucial and because its sequelae need to be distinguished from signs of abuse.

RESULT: Osteotenesis Imperfecta: Primary Care
Pediatrics in Review | Aug 1, 2010 (Free abstract. Full text $12)

It's logical to propose that drugs effective against bone loss in osteoporosis of aging might also work for OI. Watch for news on this front: Researchers are on the case. A recent multicenter randomized trial found that 2 years of treatment with oral alendronate improved bone mineral density among children and teenagers with OI, but did not reduce fractures. A small uncontrolled study from Sweden found that intravenous infusions of pamidronate appears to improve growth among prepubertal children who have OI.

RESULT:  Alendronate for the Treatment of Pediatric Osteogenesis Imperfecta: A Randomized Placebo-Controlled Study
Journal of Clinical Endocrinology and Metabolism |  Feb 1, 2011  (Free abstract. Full text $29)

RESULT:  Intravenous Pamidronate Treatment Improves Growth in Prepubertal Osteogenesis Imperfecta Patients
Hormone Research in Pediatrics | Feb 7, 2011 (Free abstract. Full text $26.50)

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