Zu viele Frakturen –Verdacht auf kindliche Osteoporose?

Zusammenfassung

Osteoporose wird zunehmend als pädiatrisches Problem bei Kindern mit genetischen und chronischen Erkrankungen wahrgenommen. Als Folge einer kindlichen Osteoporose treten typischerweise klinisch bedeutsame Frakturen auf. Das Ziel dieses Reviews ist,einen Überblicküber die mit der kindlichen Osteoporose verbundenen Probleme bezüglich Diagnose und Therapie der betroffenen Kinder und Jugend-lichen zu geben. Während der letzten Dekade wurden große Fortschritte in Bezug auf die Identifizierung von Kindern mit Osteoporose gemacht. In den Vordergrund rücken nun mehr und mehr Fragen nach den geeigneten Strategien zur Früherkennung von Kindern, die für die Entwicklung einer Osteoporose ein entsprechendes Risiko aufweisen. Diese Herangehensweise würde die Möglichkeit zur frühzeitigen Ergreifung präventiver und therapeutischer Maßnahmen eröffnen. In dieserÜbersichtsarbeit werden die Veränderungen des Knochens während desWachstums beschrieben, Probleme bezüglich derKnochendichtemessung bei Kindern erörtert und neue Strategien zur Frakturvorhersage vorgestellt. Abschließend wird der aktuelle Stand der medikamentösen Therapie bei kindlicher Osteoporose diskutiert.

Summary

Osteoporosis is increasingly recognized as an important medical problem among pediatric patients with genetic disorders and chronic illnesses. Clinically significant fractures are a hallmark of childhood osteoporosis. The goal of this review is to provide an overview of the scope of the problem in children and adolescents, highlighting the unique issues that arise from the diagnosis and treatment of osteoporosis in the growing patient. While the past decade has seen tremendous progress in the identification of pediatric osteoporosis, there is ongoing need to develop new strategies for fracture prediction in order to primarily identify children at risk of clinically relevant fractures. These approaches would then allow for the development of early intervention strategies to prevent and treat pediatric bone disease. The purpose of this review is to briefly describe changes in bone with growth, to discuss some of the issues with pediatric bone measurements, and to review recent attempts to provide precise fracture prediction in children and adolescents. In addition, current medical treatment strategies are discussed.

Schlüsselwörter

Frakturen - Knochendichte - Knochengeometrie

Keywords

Fractures - bone density - bone geometry

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