Knochenbrüche im Kindes- und Jugendalter – ein Hinweis auf Osteoporose?

Osteoporose wird zunehmend auch als ein pädiatrisches Problem bei Kindern und Jugendlichen mit genetischen und chronischen Erkrankungen wahrgenommen, in dessen Folge typischerweise klinisch bedeutsame Frakturen auftreten. Ziel dieses Reviews ist, einen Überblick über die mit der Osteoporose verbundenen Probleme bezüglich Diagnose und Therapie der betroffenen Kinder und Jugendlichen zu geben. Während der letzten Dekade wurden Fortschritte in Bezug auf die Identifizierung von Kindern und Jugendlichen mit Osteoporose erzielt. In den Vordergrund rücken nun Fragen nach wirksamen Strategien zur Früherkennung von Kindern und Jugendlichen, die für die Entwicklung einer Osteoporose ein Risiko aufweisen. Das würde die Möglichkeit frühzeitiger präventiver und therapeutischer Maßnahmen eröffnen. In diesem Review werden die Veränderungen der Knochen während des Wachstums und Probleme der Knochendichtemessung bei Kindern und Jugendlichen beschrieben sowie neue Strategien zur Frakturvorhersage vorgestellt. Abschließend wird der aktuelle Stand der medikamentösen Therapie diskutiert.

Abstract

Osteoporosis is increasingly recognized as an important paediatric problem in children and adolescents with genetic disorders and chronic diseases – with the consequence of clinically significant fractures. Goal of this review is to provide an overview of the scope of the problems, highlighting the unique issues that arise from the diagnosis and treatment in children and adolescents. While the past decade has seen 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 allow early intervention strategies. The purpose of this review is to describe changes in bone with growth, to discuss some problems of bone mineral density measurements, and to review recent attempts to provide new fracture prediction strategies in children and adolescents. In addition, current medical therapies are discussed.

Stichwörter:

Kinderheilkunde - Frakturen - Knochendichte - Knochengeometrie

Key words:

Pediatrics - Fractures - Bone density - Bone geometry

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