Keywords:
Osteoporosis, Metabolic disorders, Screening, Diagnostic procedure, CT, Musculoskeletal system, Musculoskeletal joint, Bones
Authors:
A. Balanika, P. XAFAKI, C. Baltas, H. Pergantou, H. PLATOKOUKI, N. L. Kelekis, O. Papakonstantinou; Athens/GR
DOI:
10.1594/essr2018/P-0060
Conclusion
Childhood and adolescence are critical periods for skeletal development and body mass gain and are characterize by increase of trabecular and cortical bone density and cortical bone dimensions.
Physical activity stimulates bone remodelling and can increase bone mass and strength in pre- to early pubertal.
Recent studies showed positive association between exercise during growing years and bone apposition and strength.
Hemarthrosis and reduced physical activity can alter the normal skeletal development in haemophilic patients a consequence that may leads to fractures in adult life.
A study conducted in Finnish haemophilic children showed a significant lower whole-body BMD than in controls.
Skeletal bone mass consist of 80% by cortical bone.
Primary function of cortex is mechanichal strength and it is determined by density,
geometry and microarchitecture The present study showed that were strong relationships between p-QCT bone strength indices measured at peripheral skeleton and whole body and spinal DXA BMC and BMD .
This is an important finding due to the widely use of DXA method in the assessment of bone status in hemophilic children.
Boccalandro et al in their study have found also a greater body load on the left foot of haemophilic boys independently from the hand side dominance.
In our study there is also a strong correlation of whole body DXA BMC with bone strength at the left tibia of hemophilic boys.
Also whole body and spinal DXA BMC and BMD and height were strongly associated with bone geometry.
The differences in DXA and pQCT indices between left and right extremities should be explained by the effect of hand dominance and asymmetrical natural functional differences of lower legs.
In conclusion both whole body and spinal DXA BMC and BMD in children with Haemophilia A can provide valuable informations about bone strength and biomechanical characteristics of cortical bone.