Radiographic features of bisphosphonate therapy in pediatric patients

BACKGROUND: Pediatric patients are being treated with bisphosphonates for low bone mineral density. Skeletal radiographic findings have been described with bisphosphonates given orally and intravenously. OBJECTIVE: To determine and describe the radiographic findings of cyclic intravenous bisphosphonate therapy in the growing skeleton. MATERIALS AND METHODS: Retrospective review of radiographs of 32 patients with osteogenesis imperfecta or cerebral palsy treated with intravenous bisphosphonates on a quarterly schedule. RESULTS: Principal observations were metaphyseal bands and increased bone mineral density. The bands varied in spacing according to the age of the patient, rate of growth, and the location of the metaphysis. Fractures continued to be seen in patients with osteogenesis imperfecta. CONCLUSION: Cyclic bisphosphonate therapy results in distinctive radiographic findings in the growing skeleton.