[Diagnosis, prophylaxis and therapy of osteoporosis in juvenile idiopathic arthritis: consensus statement of the German Association for Pediatric Rheumatology].
In all subgroups of juvenile idiopathic arthritis (JIA), a pathologic loss of bone or the lack of increase in bone mass has been described in a high percentage of cases, even with new therapeutic approaches. The decrease in bone mass is correlated with the duration of active disease and the number of affected joints (cytokines, inactivity). In several studies, muscle mass was the strongest predictor of bone mass. A standardized diagnostic approach to the musculoskeletal system including measures of prophylaxis and therapy therefore seems to be mandatory for all children with JIA who do not achieve rapid remission. In this review, the diagnostic and therapeutic options are described and summarized in an algorithm.
Roth
J
J
Pädiatrische Pneumologie und Immunologie, SPZ Rheumatologie, Charité Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany. johannes.roth@charite.de
Bechtold
S
S
Borte
G
G
Dressler
F
F
Girschick
H
H
Borte
M
M
D015502:Absorptiometry, Photon; D000293:Adolescent; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy; D002118:Calcium / Q000008:administration & dosage; D002648:Child; D004164:Diphosphonates / Q000008:administration & dosage; D005081:Exercise Therapy; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use; D053580:Muscle Strength / Q000502:physiology; D009133:Muscular Atrophy / Q000139:chemically induced / Q000188:drug therapy / Q000628:therapy; D010024:Osteoporosis / Q000139:chemically induced / Q000175:diagnosis* / Q000628:therapy; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014807:Vitamin D / Q000008:administration & dosage
D004164:Diphosphonates; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D014807:Vitamin D; D002118:Calcium; D008727:Methotrexate