Osteoporosis in children with physical disabilities in neurogical disorders

Abstract

Osteoporosis following chronic diseases in children, such as physical disabilities and neurological disorders, is an important health problem in pediatrics. Prolonged immobilization, nutritional disorders, medications, and hormonal alterations may cause low bone mass and fractures. The pediatrician should consider prevention and treatment of the bone disease, with emphasis on the improvement of the nutritional status and immobilization. Hypercalcemia has often been observed, but prevalence and etiology are not well understood. Continuing research is necessary to improve bone health in this group of children. Bone mass has to be studied at presentation and during the growth period, with special attention to height and skeletal maturation in order to explain DXA results. Drugs that are toxic for the bone should be used with moderation. If, in spite of these considerations, bone mass is low and fractures occur, treatment with bisphosphonates should be evaluated.