Related Experiment Videos
Epi- and metaphyseal changes in children caused by administration of bisphosphonates
E L van Persijn van Meerten1, H M Kroon, S E Papapoulos
1Department of Diagnostic Radiology, University Hospital Leiden, The Netherlands.
Insights
Nitrogen-containing bisphosphonates (NCBs) cause reversible bone changes in children, including sclerosis and unique spinal appearances. Effects correlate with growth activity and treatment duration.
Area of Science:
- Pediatric Radiology
- Skeletal Biology
- Pharmacology
Background:
- Nitrogen-containing bisphosphonates (NCBs) are effective in treating adult bone disorders.
- Limited data exists on NCB effects on the pediatric growing skeleton.
Purpose of the Study:
- To investigate the skeletal effects of NCBs in children.
- To describe radiographic changes associated with NCB treatment in pediatric patients.
Main Methods:
- Retrospective analysis of skeletal radiographs from nine children.
- Radiographs were obtained before, during, and after NCB administration.
Main Results:
- All patients exhibited bandlike metaphyseal sclerosis and concentric epi-/apophyseal sclerosis.
- Spinal changes included "picture-frame" or "bone-within-bone" appearances.
- Metaphyseal undertubulation was observed in five patients; changes were reversible upon discontinuation.
Conclusions:
- NCBs induce characteristic, reversible radiographic changes in the growing skeleton.
- Sclerosis extent correlates with treatment duration and skeletal growth activity.
- Radiographic findings are dependent on growth plate activity and treatment cessation.
Abstract:
Nitrogen-containing bisphosphonates (NCBs) are potent inhibitors of bone resorption and are used in the treatment of adults with various skeletal disorders. Little is known about their effects on the growing skeleton. The authors retrospectively studied the skeletal radiographs obtained in nine children before, during, and after NCB administration. Bandlike metaphyseal sclerosis and concentric epi- and apophyseal sclerosis developed in all patients. The extent of sclerosis depended on the duration of treatment and was related to local, and probably general, skeletal growth activity. In the maturing spine, NCBs caused a "picture-frame" or "bone-within-bone" appearance, depending on continuation or cessation of administration. In addition, metaphyseal undertubulation of long bones was noted in five patients. After discontinuation of bisphosphonate treatment and/or closure of the growth plates, the degree of sclerosis decreased, and sclerosis tended to disappear, indicating that this is a reversible phenomenon.