International Journal of Clinical Case Reports 2017, Vol.7, No.7, 28-32
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Table 1 Differential Diagnosis of Repeated Childhood Fractures
Diseases
Osteogenesis imperfecta (OI)
Juvenile Paget’s disease
Rickets
Juvenile osteoporosis
Background
Defects in osteoblasts
Increased bone resorption (abnormal bone
architecture)
Insufficient calcification of the matrix (soft
bones)
Reduced formation of organic
matrix (decreased bone mass)
Clinical features
Bone fractures, spinal curvature,
loose joints, poor muscle tone,
blu
Widespread skeletal involvement presenting in
childhood with progressive deformities, short
stature, growth retardation, progressive
macrocephaly and facial deformity
Bone tenderness
problems
weakness, "floppy baby syndrome" or, "slinky
baby syndrome", increased tendency for
especially,
Usually secondary to some other
condition, e.g.
(OI)
r
Characteristic
radiographic
features
Wormian/sutural bones
Characteristic mosaic pattern (both osteolysis
and osteosclerosis) are diagnostic of Paget’s
disease
Bowed legs (outward curve of long bones of
the legs), deformed chest, changes in the skull,
a distinctive "square headed" appearance,
permanent bends or, disfiguration of the long
bones
Confirmed radiologically by the
presence of generalized osteopenia
Lab investigations
Calcium
Phosphorus
Alkaline
phosphatase
Normal
Normal
High
Low
Low
High
Normal
Normal
Normal
