Muscle-Bone Interactions in Pediatric Bone Diseases

Abstract

Purpose: Here, we review the skeletal effects of pediatric muscle disorders as well as muscle impairment in pediatric bone disorders.

Recent findings: When starting in utero, muscle disorders can lead to congenital multiple contractures. Pediatric-onset muscle weakness such as cerebral palsy, Duchenne muscular dystrophy, spinal muscular atrophy, or spina bifida typically are associated with small diameter of long-bone shafts, low density of metaphyseal bone, and increased fracture incidence in the lower extremities, in particular, the distal femur. Primary bone diseases can affect muscles through generic mechanisms, such as decreased physical activity or in disease-specific ways. For example, the collagen defect underlying the bone fragility of osteogenesis imperfecta may also affect muscle force generation or transmission. Transforming growth factor beta released from bone in Camurati Engelman disease may decrease muscle function.

Future directions: Considering muscle-bone interactions does not only contribute to the understanding of musculoskeletal disorders but also can identify new targets for therapeutic interventions.

Keywords: Arthrogryposis multiplex congenita; Cerebral palsy; Duchenne muscular dystrophy; Osteogenesis imperfecta; X-linked hypophosphatemic rickets.