Assessing the skeleton in children and adolescents with disabilities: Avoiding pitfalls, maximising outcomes. a guide for the general paediatrician

Abstract

Assessment of bone health of a young person with a severe disability is complex. Age of onset of disability, degree of physical limitation, nutritional status, calcium and vitamin D intake and pubertal progress all contribute to adult outcomes. Concomitant medical conditions may further adversely affect bone accrual. Bone quality, until growth is complete, must be interpreted in light of growth, height and puberty. For those children and adolescents who have disabilities where weight bearing is limited, satisfactory and reproducible measurements of bone density may be impossible to obtain. Fracture risk is dependent on the degree of immobilisation and on bone quality at any age. Meeting the ..