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Bone densitometry in pediatric patients treated with pamidronate

Leslie E Grissom1, Heidi H Kecskemethy, Steven J Bachrach

  • 1Department of Medical Imaging, Alfred I. duPont Hospital for Children, Nemours Children's Clinic, P.O. Box 269, Wilmington, DE 19899, USA. lgrissom@nemours.org

Pediatric Radiology
|January 19, 2005
PubMed

Insights

Intravenous pamidronate effectively increased bone mineral density in children with osteogenesis imperfecta and cerebral palsy. While bone density improved, children with osteogenesis imperfecta continued to experience fractures at a reduced rate.

Area of Science:

  • Pediatric Endocrinology
  • Pediatric Orthopedics
  • Pediatric Rheumatology

Background:

  • Bisphosphonate therapy, specifically pamidronate, is increasingly used for pediatric low bone mineral density.
  • Children at high risk for fractures due to bone disorders or limited mobility are primary candidates for this treatment.

Purpose of the Study:

  • To evaluate the efficacy of intravenous pamidronate in enhancing bone mineral density (BMD) in pediatric patients.
  • Specifically assessed outcomes in children diagnosed with osteogenesis imperfecta (OI) and spastic quadriplegic cerebral palsy (CP).

Main Methods:

  • Retrospective chart review of 38 children (20 with OI, 18 with CP) treated with pamidronate.
  • Patients selected based on prior fractures or significantly low BMD.
  • Treatment involved intravenous pamidronate administered every 2-8 months, with BMD assessed via dual-energy X-ray absorptiometry (DXA).

Main Results:

  • Significant BMD improvements were observed in 31 of 32 patients.
  • Average BMD increase was 78% in OI and 47.4% in CP patients at the lumbar spine.
  • Femur BMD increased by 96% in OI and 65.7% in CP patients, exceeding age-expected growth.
  • Children with CP ceased fracturing after treatment initiation; OI patients had a reduced fracture rate.

Conclusions:

  • Intravenous pamidronate is effective for increasing BMD in pediatric patients with OI and CP.
  • While both groups showed BMD gains, OI patients continued to fracture less frequently.
  • Children with CP experienced significant BMD increases and fracture cessation.
Abstract

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