What Do Bones Have to Do with Crohn's?

Bone growth measurement recommended for pediatric Crohn's

(RxWiki News) What does the “age” of a child's bones have to do with Crohn's disease? It may sound strange, but poor bone growth is a sign of the disease's toll on a pediatric Crohn's patient.

Crohn's disease can impede growth and delay puberty for children and their bones may be less developed than their peers.

According to a new study, a child's bone age should be measured as part of routine care, in order to assess their growth and decide on the best course of treatment.

"Ask your pediatrician about measuring bone age."

The study was led by Dr. Neera Gupta, a pediatric gastroenterologist at the University of California - San Francisco Benioff Children’s Hospital. The research is important, because a child's growth is one of the factors that doctors use to decide on therapy for children.

In pediatric patients, the gastrointestinal inflammation that characterizes Crohn's can prevent a child from growing normally. About 25 percent of the one million Americans with Crohn's are diagnosed in childhood and adolescence.

A child's chronological age may not match their bone age. Bone age is assessed by looking at X-rays of bones and growth plates and matching them to images of standard bone development.

For example, a child with Crohn's who is six years old might have a skeleton that looks more like a five year old's. The difference between chronological age and bone age can indicate a growth problem.

In this study, the researchers looked at left hand and wrist X-rays of nearly 50 pediatric Crohn's patients, ranging from five to 17 years old. They found that 41 percent of study participants had low bone age, or delayed bone development.

“I did not expect that such a large proportion of patients would have this degree of delay,” Dr. Gupta said in a press release.

Females typically had lower bone age compared to males. Factors related to low bone age include white race, exposure to steroids, the location of the disease and type of treatment.

The inflammation that comes with Crohn's is usually results in symptoms such as abdominal pain, rectal bleeding and diarrhea. But in some cases, the disease may be active without these symptoms. Poor growth may be one of the only ways to tell if the disease is active, Dr. Gupta said.

She believes that adding a measurement of bone age to interpret the patient's expected growth could lead to better treatment.

The study was published in May 2012 in the journal Inflammatory Bowel Diseases.

Review Date: 
June 1, 2012