Canadian Paediatric Surveillance Program
The Changing Face of Bone Diseases
CPSP Concurrent Session on Bone Diseases at the CPS Annual Meeting – Montreal, Quebec – June 2004
Practicing paediatricians are questioning the re-emergence of nutritional rickets in the Canadian population and are aware of the seriousness and life-long disabilities of children and youth with osteogenesis imperfecta.
This session will provide timely insight into the importance of prevention and early recognition of these two conditions. It will also increase awareness of their serious clinical and public health implications.
A review of the important risk determinants and of the investigations needed to adequately assess these infants and children will be presented together with national incidence data to further define the epidemiological profile.
Chair: Dr. Charles Scriver will provide background information on the important role of vitamin D in rickets prevention and the advocacy needed for vitamin D supplementation of milk in Canada in the 1950s. He will also review the importance of implementing genetic screening for rare paediatric diseases and disorders.
Vitamin D deficiency rickets (VDDR) among children living in Canada: A new look at an old disease.
Dr. Leanne M Ward will present results of VDDR surveillance through the CPSP highlighting that:
- Nutritional rickets is occurring in Canada.
- A sub-set of residents in Canada is particularly at risk.
- Significant morbidity accompanies rickets diagnosis including fractures, limb deformities, poor growth and delayed gross motor milestones.
- All exclusively breast-fed infants should receive vitamin D supplementation as recommended by the CPS.
The many faces of Osteogenesis imperfecta(OI)
Dr. Francis Glorieux will review surveillance results of OI through the CPSP showing that it has:
- Increased awareness of the clinical spectrum of OI from four recognized types to possibly seven.
- Helped define the genetic basis of OI types V-VII.
- Emphasized the importance of early diagnosis to take advantage of the window of opportunity for starting beneficial oral treatment in infancy.
- Educated the medical community on how to differentiate the abused child from the child with congenital bone fragility due to OI.
Objectives: The session will enable participants to:
- Understand how an active surveillance program works.
- Recognize how surveillance data can improve management of these two bone conditions.
- Appreciate how surveillance results can influence public health policies.
- Realize how knowledge acquired through surveillance benefits patients and families.
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