The
Center for the Prevention of Osteoporosis in Children
is being developed with the realization that adult osteoporosis begins in childhood. A great deal of attention has been given to prevention of coronary artery disease (i.e. heart attacks) in adulthood by altering the dietary habits of children. Little focus has been given to the prevention of osteoporosis. This center is being established for the treatment of known causes of osteoporosis in children as well as for the treatment of children with risk factors or evidence of osteoporosis in childhood. A secondary goal of the center will be to establish protocols in the management of children in the attempt to increase bone density. There is no data available regarding the normal bone density of children during the various stages of growth. The data for DEXA scan is not applicable for children. We will be looking to establish normative data.
The first group of patients are children who are considered "normal" children. They may be children being seen for fractures in which the treating physician feels that by radiographic evidence the
child has osteoporosis (osteomalacia) or children who are getting insufficient sunlight, calcium or exercise and are at risk for osteoporosis. This group may also include children with a strong family history of
osteoporosis. Children who engage in excessive exercise will also be evaluated due to their increased risk for osteoporosis. These children will undergo metabolic as well as wrist DEXA scanning to determine
if there is an underlying cause of the osteomalacia and then secondarily may have therapeutic intervention. The children will be followed by serial wrist DEXA scanning to determine the efficacy of intervention.
The second group of children are those with known metabolic bone disease such as rickets or osteogenesis imperfecta. These children will be treated with both approved and experimental medications in an
attempt to improve bone density. Outcome measures such as direct bone density measurements as well as fracture occurrence will be evaluated.
The third group of children will be those children with an
underlying disease that has associated with it a high risk for fracture secondary to osteoporosis. Neuromuscular diseases such as cerebral palsy, spina bifida and muscular dystrophy have a high incidence of
osteoporosis (osteomalacia) and fracture. Other disease states such as familial dysautonomia may also be studied. The attempt to monitor and treat these patients decreasing bone density will be performed.
Therapeutic modalities may include dietary alteration and supplementation, appropriate medications, vitamins, an exercise program or rarely surgery. An interdisciplinary team headed by a pediatrician
and including an endocrinologist, nutritionist, geneticist, orthopedic surgeon, physiatrist, nurse, physical and occupational therapist will be involved in the management and ongoing treatment of these children.
It is the goal of this center to not only treat the children directly but also to write protocols and journal papers and hold seminars that will educate parents, coaches and medical providers in maximizing
the musculoskeletal health of children.
To schedule an appointment or to obtain additional information, please contact
(212) 598-2330 or email us at
