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Osteoporosis International
Published in: Osteoporosis International 11/2017

01-11-2017 | Original Article

Musculoskeletal health in newly diagnosed children with Crohn’s disease

Authors: L. M. Ward, J. Ma, F. Rauch, E. I. Benchimol, J. Hay, M. B. Leonard, M. A. Matzinger, N. Shenouda, B. Lentle, H. Cosgrove, M. Scharke, V. N. Konji, D. R. Mack

Published in: Osteoporosis International | Issue 11/2017

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Abstract

Summary

We evaluated the impact of Crohn’s disease on muscle and bone strength, mass, density, and geometry in children with newly diagnosed CD and found profound muscle and bone deficits; nevertheless, the prevalence of vertebral fractures at this time point was low.

Introduction

Crohn’s disease (CD) is an inflammatory condition of the gastrointestinal tract that can affect the musculoskeletal system. The objective of this study was to determine the prevalence of vertebral fractures and the impact of CD on muscle and bone mass, strength, density, and geometry in children with newly diagnosed CD.

Methods

Seventy-three children (26 girls) aged 7.0 to 17.7 years were examined within 35 days following CD diagnosis by lateral spine radiograph for vertebral fractures and by jumping mechanography for muscle strength. Bone and muscle mass, density, and geometry were assessed by dual-energy x-ray absorptiometry and peripheral quantitative computed tomography (pQCT).

Results

Disease activity was moderate to severe in 66 (90%) patients. Mean height (Z-score −0.3, standard deviation (SD) 1.1, p = 0.02), weight (Z-score −0.8, SD 1.3, p < 0.01), body mass index (Z-score −1.0, SD 1.3, p < 0.01), lumbar spine areal bone mineral density (BMD; Z-score −1.1, SD 1.0, p < 0.01), total body bone mineral content (Z-score −1.5, SD 1.0, p < 0.01), and total body lean mass (Z-score −2.5, SD 1.1, p < 0.01) were all low for age and gender. pQCT showed reduced trabecular volumetric BMD at the tibial metaphysis, expansion of the bone marrow cavity and thin cortices at the diaphysis, and low calf muscle cross-sectional area. Jumping mechanography demonstrated low muscle power. Only one patient had a vertebral fracture.

Conclusions

Children with newly diagnosed CD have profound muscle and bone deficits; nevertheless, the prevalence of vertebral fractures at this time point was low.
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Metadata
Title
Musculoskeletal health in newly diagnosed children with Crohn’s disease
Authors
L. M. Ward
J. Ma
F. Rauch
E. I. Benchimol
J. Hay
M. B. Leonard
M. A. Matzinger
N. Shenouda
B. Lentle
H. Cosgrove
M. Scharke
V. N. Konji
D. R. Mack
Publication date
01-11-2017
Publisher
Springer London
Published in
Osteoporosis International / Issue 11/2017
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-017-4159-0

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