The Pediatric Bone Health Clinic provides comprehensive care to infants, children, and adolescents with metabolic bone disorders. Childhood is a critical time for the attainment of bone mass, which impacts lifelong skeletal health. For children with rare bone diseases such as those with bone fragility or heritable forms of rickets, early diagnosis and treatment are necessary to ensure proper bone health.  Children can also be at risk for developing low bone mass and osteoporosis due to an underlying chronic disease. Early identification of the risk factors and prevention of osteoporosis through modifications in nutrition, physical activity, calcium, and vitamin D intake are key to optimize bone health in children.

In the Pediatric Bone Health Clinic, patients receive individualized assessment and care-plans, including:

• Clinical evaluation for screening and diagnosis of metabolic bone disorders
• Laboratory evaluation of bone minerals, such as calcium, phosphorus, and vitamin D metabolites
• Imaging studies including x-rays
• Dual-energy X-ray absorptiometry (DXA) scans to measure bone mineral density
• Genetic testing for rare metabolic bone disorders such as osteogenesis imperfecta, hypophosphatemic rickets and hypophosphatasia
• Treatment as indicated, including bisphosphonate infusions

Conditions Evaluated and Managed in the Pediatric Bone Health Clinic

Many of the children seen in the Pediatric Bone Health Clinic have a significant history of fragility fractures or rickets with bone deformities. In addition, patients are seen with other rare metabolic bone disorders such as osteogenesis imperfecta, fibrous dysplasia, McCune-Albright syndrome, hypophosphatasia, osteopetrosis, and X-linked hypophosphatemic rickets to list a few. An extensive list of the conditions for referral includes:

• Calcium disorders (hypocalcemia, hypercalcemia)
• Parathyroid disorders (hypoparathyroidism, hyperparathyroidism, pseudohypoparathyroidism)
• Disorders of vitamin D metabolism
• Fibrous dysplasia/McCune-Albright Syndrome
• Hypophosphatasia
• Hypophosphatemia
• Low bone density
• Osteoporosis
• Multiple or fragility fractures
• Osteogenesis Imperfecta
• Rickets

Innovative Therapeutic Approaches Offered in the Pediatric Bone Health Clinic

Over the past decades, a multitude of therapies have become available for many of the metabolic bone disorders that affect children, including enzyme replacement therapy and monoclonal antibodies.    In addition, there are many indications for the off-label use of bisphosphonates in pediatric patients, including primary and secondary osteoporosis, osteogenesis imperfecta, bone pain, and hypercalcemia to name a few.  In the Pediatric Bone Health Clinic, we can treat children safely and effectively with these infusions based on standard protocols.