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Skeletal changes in preterm infants: personal experience
Insights
Skeletal changes in preterm infants are increasing. Radiology can detect rickets, but bone densitometry is better for early osteoporosis detection in these vulnerable infants.
Area of Science:
- Neonatalogy
- Pediatric Radiology
- Skeletal Development
Background:
- Rising incidence of skeletal abnormalities in preterm, low-birth-weight infants.
- Increased survival rates of high-risk neonates contribute to this trend.
- Biochemical markers and clinical signs for skeletal pathology in neonates are often non-specific or delayed.
Purpose of the Study:
- To evaluate the utility of radiological methods in diagnosing skeletal pathology in preterm infants.
- To compare the sensitivity of radiology versus densitometry for detecting osteopenia and rickets.
- To propose a follow-up strategy for skeletal assessment in preterm infants.
Main Methods:
- Retrospective analysis of 8 preterm infants with documented skeletal pathology.
- Review of radiological findings, including X-rays.
- Comparison of radiological assessment with biochemical data and clinical presentation.
Main Results:
- Radiology effectively identified rachitic changes in preterm infants.
- Radiological methods showed limited sensitivity in detecting minimal osteoporotic changes.
- Densitometric studies are recommended for more accurate assessment of osteopenia.
Conclusions:
- Radiology plays a role in identifying overt skeletal changes like rickets in preterm infants.
- Densitometry is superior for detecting early or subtle osteoporotic modifications.
- A suggested radiological skeletal follow-up from 5 to 12 weeks of life is proposed in the absence of densitometry.
Abstract:
The incidence of skeletal changes in preterm low-birth-weight infants is rising. This is probably related to today's higher survival rate of these babies. The late positivity of biochemical data and the lack of clinical prognostic signs justify the role of radiology in such pathology. Radiology, however, although useful in detecting rachitic changes, seems to be less sensitive to minimal osteoporotic modifications, for which densitometric studies should be preferred. The authors report their personal experience in 8 cases of skeletal pathology in preterm infants and suggest a radiological follow-up of the skeleton from the 5th to the 12th week of life, whenever a densitometric method is not available.