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Osteogenesis imperfecta

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Brittle bone disease

Treatment:

There is not yet a cure for this disease. However, specific therapies can reduce the pain and complications associated with OI.

Bisphosphonates are drugs that have been used to treat osteoporosis. They have proven to be very valuable in the treatment of OI symptoms, particularly in children. These drugs can increase the strength and density of bone in persons with OI. They have been shown to greatly reduce bone pain and fracture rate (especially in the bones of the spine).

Low impact exercises such as swimming keep muscles strong and help maintain strong bones. Such exercise can be very beneficial for persons with OI and should be encouraged.

In more severe cases, surgery to place metal rods into the long bones of the legs may be considered to strength the bone and reduce the risk of fracture. Bracing can also be helpful for some people.

Reconstructive surgery may be needed to correct any deformities. Such treatment is important because deformities (such as bowed legs or a spinal problem) can significantly affect a person's ability to move or walk.

Regardless of treatment, fractures will occur. Most fractures heal quickly. Time in a cast should be limited since bone loss (disuse osteoporosis) may occur when you do not use a part of your body for a period of time.

Many children with OI develop body image problems as they enter their teenage years. A social worker or psychologist can help them adapt to life with OI.

Expectations (prognosis):

How well a person does depends on the type of OI they have.

• Type I, or mild OI, is the most common form. Persons with this type can live a normal lifespan.
• Type II is a severe form that is usually leads to death in the first year of life.
• Type III is also called severe OI. Persons with this type have many fractures starting very early in life and can have severe bone deformities. Many become wheelchair bound and usually have a somewhat shortened life expectancy.
• Type IV, or moderately severe OI, is similar to type I, although persons with type IV often need braces or crutches to walk. Life expectancy is normal or near normal.

There are other types of OI, but they occur very infrequently and most are considered subtypes of the moderately severe form (type IV).

Complications:

Complications are largely based on the type of OI present. They are often directly related to the problems with weak bones and multiple fractures.

Complications may include:

• Hearing loss (common in type I and type III)
• Heart failure (type II)
• Respiratory problems and pneumonias due to chest wall deformities
• Spinal cord or brain stem problems
• Permanent deformity

Calling your health care provider:

Severe forms are usually diagnosed early in life, but mild cases may not be noted until later in life. Make an appointment with your health care provider if you or your child have symptoms of this condition.

• Review Date: 7/3/2007
• Reviewed By: Benjamin David Roye, M.D., Assistant Professor, Department of Orthopaedics, Division Chief Pediatric Orthopaedics, Mount Sinai School of Medicine, New York, NY, and Neal Sondheimer, M.D., Ph.D., Section of Biochemical Genetics, Children's Hospital of Philadelphia, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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