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- Title
Quantitative ultrasound of the calcaneus in children and young adults with severe cerebral palsy.
- Authors
Maja Jekovec-Vrhovšek; Andreja Kocijančič; Janez Preželj
- Abstract
Osteopenia is common in children, adolescents, and young adults with severe cerebral palsy (CP; spastic quadriplegia) living in residential care, and frequently results in atraumatic fractures. On clinical grounds 67 patients (34 males, 33 females) with severe CP (Gross Motor Function Classification System [GMFCS] levels IV or V) aged 5 to 25 years (median 20y) were divided into three groups with increasing likelihood of severe impairment of bone quality: (1) patients without fractures and without anticonvulsant medication (n=13); (2) patients without fractures and with anticonvulsant medication (n=45); (3) patients with fractures and with anticonvulsant medication (n=9). Evaluation included measurements of quantitative ultrasound (QUS) of the calcaneus, multiple serum analyses, and determination of urinary bone-resorption markers. Values of the quantitative ultrasound index (QUI) were significantly different (p=0.001): group 1 (median 56.9; interquartile range 43.8–75.3); group 2 (49.9; 40.0–60.0); group 3 (35.6; 30.5–38.5). When comparing values of laboratory serum and urine in the three groups, we found significant differences in values of serum bone alkaline phosphatase (p=0.001), serum parathyroid hormone (PTH; p=0.002), serum albumin (p=0.020), and urinary deoxypyridinoline/creatinine ratio (p=0.004). In multiple regression analysis, no laboratory variable was found to be an independent predictor of QUI. QUS of the calcaneus may be a useful method to assess bone quality and fracture risk in children and young adults with severe CP living in residential care, independent of information from laboratory data.
- Subjects
CEREBRAL palsy; OSTEOPENIA; CHILDREN with cerebral palsy; BRAIN-damaged children; ANTICONVULSANTS; CREATININE
- Publication
Developmental Medicine & Child Neurology, 2005, Vol 47, Issue 10, p696
- ISSN
0012-1622
- Publication type
Article
- DOI
10.1017/S0012162205001416