title: Bisphosphonate treatment for children with disabling conditions.
abstract: Fractures are a frequent source of morbidity in children with disabling conditions. The assessment of bone density in this population is challenging, because densitometry is influenced by dynamic forces affecting the growing skeleton and may be further confounded by positioning difficulties and surgical hardware. First-line treatment for pediatric osteoporosis involves conservative measures, including optimizing the management of underlying conditions, maintaining appropriate calcium and vitamin D intake, encouraging weight-bearing physical activity, and monitoring measurements of bone mineral density. Bisphosphonates are a class of medications that increase bone mineral density by inhibiting bone resorption. Although bisphosphonates are commonly prescribed for treatment of adult osteoporosis, their use in pediatric patients is controversial because of the lack of long-term safety and efficacy data.
authors.affiliation: Division of Endocrinology and Diabetes, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC 20010; and Bone Health Program, Division of Orthopaedics and Sports Medicine, Children's National Medical Center, Washington, DC(∗). Electronic address: aboyce@childrensnational.org.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Boyce
authors.affiliation: Bone Health Program, Division of Orthopaedics and Sports Medicine, Children's National Medical Center, Washington, DC(†).
authors.forename: Laura L
authors.initials: LL
authors.lastname: Tosi
authors.affiliation: Rehabilitation Medicine Department, Mark O. Hatfield Clinical Research Center, National Institutes of Health, Bethesda, MD(‡).
authors.forename: Scott M
authors.initials: SM
authors.lastname: Paul
mesh_terms: D015502:Absorptiometry, Photon; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000209:etiology; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016723:Bone Remodeling / Q000502:physiology; D001842:Bone and Bones / Q000000981:diagnostic imaging; D001930:Brain Injuries / Q000150:complications; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D004164:Diphosphonates / Q000494:pharmacology / Q000627:therapeutic use*; D005357:Fibrous Dysplasia of Bone / Q000150:complications; D006801:Humans; D051346:Mobility Limitation; D009043:Motor Activity / Q000502:physiology; D020388:Muscular Dystrophy, Duchenne / Q000150:complications; D010013:Osteogenesis Imperfecta / Q000150:complications; D010024:Osteoporosis / Q000188:drug therapy* / Q000209:etiology; D013119:Spinal Cord Injuries / Q000150:complications; D016135:Spinal Dysraphism / Q000150:complications; D014463:Ultrasonography
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates