Kids with arthritis at increased risk of fracture

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Children with arthritis have a significantly increased risk of fracture in childhood, adolescence, and possibly adulthood, a study shows.

“Prior to the publication of our study, it was unknown whether these kids were at increased risk for fracture during childhood, adulthood, or both,” Dr. Jon Michael (Sandy) Burnham, of the Children’s Hospital of Philadelphia, Pennsylvania told Reuters Health.

“The findings suggest that we need to intervene to at least preserve and, more likely, to augment skeletal health during childhood and maximize peak bone mass accrual,” he added.

It is important to make sure that arthritis is well controlled. “Active arthritis and the immobility that results is likely to exacerbate osteoporosis related to childhood arthritis,” Burnham explained.

“Next, we need to make sure that children meet the dietary requirements for calcium intake and remain vitamin D replete,” he noted. “Last, we need to develop better clinical tools to diagnose and monitor children at risk for osteoporosis.”

In the study of 1939 children diagnosed with arthritis between the age of 1 and 9 years and 207,072 healthy control children, significantly more fractures were recorded in the children with arthritis than in control children.

A total of 129 (6.7 percent) first fractures were recorded in the patients with arthritis, compared with 6910 (3.3 percent) in the control subjects.

Compared with controls, the “incident rate ratio” for first fracture among those with arthritis, according to the age at the start of follow-up, was 1.49 for age younger than 10 years, 3.13 for ages between 10 and 15 years, and 1.75 for ages 15 to 20 years.

For ages 20 to 45 years and older than 45, the IRRs among patients with arthritis were 1.40 and 3.97, respectively.

Fractures in arthritis sufferers occurred predominantly in the arms and legs, Burnham and colleagues report in the Annals of Rheumatic Diseases.

SOURCE: Annals of Rheumatic Disease August 2006.

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