Internal Medicine

0521779407-16 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:18

Osteogenesis Imperfecta Osteomalacia and Rickets 1099

■Bisphosphonate therapy, oral (alendronate, residronate) or intra-

venous (pamidronate; zoledronic acid not reported): decreases frac-

ture rate, increases bone density in children. In adults may increase

bone density transiently, but effect on fracture rate not defined.

Physical Therapy

■Rehabilitation after fractures: Limit immobilization, counteract joint

hyperextensibility, maintain gait

■Pool therapy

■Maintain strength and function in upper and lower extremities

follow-up

■Pulmonary function studies

■DXA bone density

■Maintain adequate calcium and vitamin D intake

complications and prognosis

■Type II OI dies shortly after birth

■Pulmonary insufficiency in type III

■Neurologic complications due to posterior fossa and spinal cord

compression in basilar invagination

■Hearing loss in 2nd-3rd decade

■Significant aortic or mitral insufficiency rarely occurs

■Renal calculi

■Traumatic injury is main risk: patients may live to 70s

OSTEOMALACIA AND RICKETS

DAVID FELDMAN, MD

history & physical

History

■Decreased dietary intake of vitamin D

■Deficient sun exposure

■Growth retardation

■Fractures

■Family history

■Kidney disease

■Chronic diarrhea