title: [Bone mineral density in children. Association with musculoskeletal pain and/or joint hypermobility].
abstract: OBJECTIVE
  Joint hypermobility can be associated with benign musculoskeletal pain. The relation between hypermobility and low bone mineral density is still unknown. Osteoporosis can be observed in some genetic syndromes associated with joint hypermobility. The aim of our study was to detect the possible relation between joint hypermobility, benign musculoskeletal pain and bone mineral density in children.
  
  
  METHODS
  Ninety-three children from 5 to 10 years of age were evaluated concerning the presence of joint hypermobility and the presence of musculoskeletal pain based on a questionnaire directed to parents. We also performed densitometry to measure bone mineral density. All children underwent an L2-L4 lumbar bone densitometry.
  
  
  RESULTS
  Children were distributed into four groups according to the presence or not of joint hypermobility associated or not with musculoskeletal pain: 29 (31.2%) with hypermobility and pain, 20 (21.5%) with hypermobility and without pain, 22 (23.6%) without hypermobility and with pain and 22 (23.6%) without hypermobility and without pain (control group). Twenty-four children (25.8%) presented reduction in bone mineral density over 10% related to the adequate bone mineral density for age and gender. Bone mineral density was significantly lower in relation to the controls in the following groups: with hypermobility (independently of the presence of pain), with pain (independently of the presence of hypermobility), with hypermobility and without pain and without hypermobility and with pain.
  
  
  CONCLUSIONS
  Bone mineral density may be lower in children with joint hypermobility (independently of musculoskeletal pain) and in children with pain (independently of hypermobility) when compared to controls.
authors.affiliation: Departamento de Pediatria, Universidade Federal de São Paulo, SP.
authors.forename: Adriana Madureira
authors.initials: AM
authors.lastname: Roberto
authors.forename: Maria Teresa R A
authors.initials: MT
authors.lastname: Terreri
authors.forename: Vera
authors.initials: V
authors.lastname: Szejnfeld
authors.forename: Maria Odete E
authors.initials: MO
authors.lastname: Hilário