Sclerotic metaphyseal lines in children and adolescents treated with alendronate.
BACKGROUND
Bisphosphonates inhibit bone resorption by interfering with the action of osteoclasts. Among the adverse effects, sclerotic lines observed in the metaphysis of long bones have been described as the main imaging finding in pediatric patients.


OBJECTIVE
To evaluate the frequency of radiographic changes caused by alendronate in children and adolescents with low bone density or calcinosis.


METHODS
We conducted a cross-sectional study with 21 patients who were treated with once-weekly alendronate for at least 10 months. Patients underwent x-rays of long bones before the start of alendronate and approximately one year after its use.


RESULTS
Eleven patients (52.3%) had sclerotic lines in the metaphysis of long bones. The most frequent site was the tibia (8/11 patients), followed by the femur (7/11), humerus (6/11), radius (4/11), ulna (3/11), and fibula (2/11). Regression of radiographic changes during the study period (up to 1.1 years after discontinuation of alendronate) was not observed.


CONCLUSIONS
If used carefully, alendronate is safe and radiographic changes have not been shown to be clinically relevant.
Pediatric Rheumatology Department, Universidade Federal de São Paulo (UNIFESP-EPM), Brazil.
Erika C C
EC
Silva
Maria Teresa R A
MT
Terreri
Tania C M
TC
de Castro
Cássia P L
CP
Barbosa
Artur R C
AR
Fernandes
Maria Odete E
MO
Hilário
D000293:Adolescent; D019386:Alendronate / Q000009:adverse effects* / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000187:drug effects* / Q000473:pathology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D012598:Sclerosis; D055815:Young Adult
D050071:Bone Density Conservation Agents; D019386:Alendronate