Monitoring Bone Health in Children with Hemophilic Arthropathy: Where Do We Stand?
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Osteoporosis is a systemic skeletal disease characterized by low bone mass and/or altered bone micro-architecture which results in decreased bone strength and increased risk for fractures. Children with hemophilic arthropathy are at an increased risk for secondary osteoporosis, which is contributed by following factors: a) reduced weight bearing and decreased muscle mass resulting in impaired muscle-bone cross talk, b) prolonged immobilization and c) associated co-morbidities (such as infections).
Bone mineral density (BMD) measured using dual-energy X-ray absorptiometry (DXA) is a strong predictor of future fracture risk, and is currently considered the gold standard for diagnosing osteoporosis. While BMD provides a good estimate of bone quantity, it fails to measure bone micro-architecture (or bone quality), which is an independent marker of bone health. Trabecular bone score (TBS) has recently emerged as a tool for measuring bone micro-architecture and has been shown to have a good...
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- 3.El-Mikkawy DME, Elbadawy MA, Abd El-Ghany SM, Samaha D. Serum sclerostin level and bone mineral density in pediatric hemophilic arthropathy. Indian J Pediatr. 2019. https://doi.org/10.1007/s12098-019-02855-1.