{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:40:36Z","timestamp":1780472436594,"version":"3.54.1"},"reference-count":57,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2010,3,30]],"date-time":"2010-03-30T00:00:00Z","timestamp":1269907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2010,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Vertebral fractures are an under\u2010recognized problem in children with inflammatory disorders. We studied spine health among 134 children (87 girls) with rheumatic conditions (median age 10 years) within 30 days of initiating glucocorticoid therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children were categorized as follows: juvenile dermatomyositis (n = 30), juvenile idiopathic arthritis (n = 28), systemic lupus erythematosus and related conditions (n = 26), systemic arthritis (n = 22), systemic vasculitis (n = 16), and other conditions (n = 12). Thoracolumbar spine radiograph and dual x\u2010ray absorptiometry for lumbar spine (L\u2010spine) areal bone mineral density (BMD) were performed within 30 days of glucocorticoid initiation. Genant semiquantitative grading was used for vertebral morphometry. Second metacarpal morphometry was carried out on a hand radiograph. Clinical factors including disease and physical activity, calcium and vitamin D intake, cumulative glucocorticoid dose, underlying diagnosis, L\u2010spine BMD Z score, and back pain were analyzed for association with vertebral fracture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirteen vertebral fractures were noted in 9 children (7%). Of these, 6 patients had a single vertebral fracture and 3 had 2\u20133 fractures. Fractures were clustered in the mid\u2010thoracic region (69%). Three vertebral fractures (23%) were moderate (grade 2); the others were mild (grade 1). For the entire cohort, mean \u00b1 SD L\u2010spine BMD Z score was significantly different from zero (\u22120.55 \u00b1 1.2, <jats:italic>P<\/jats:italic> &lt; 0.001) despite a mean height Z score that was similar to the healthy average (0.02 \u00b1 1.0, <jats:italic>P<\/jats:italic> = 0.825). Back pain was highly associated with increased odds for fracture (odds ratio 10.6 [95% confidence interval 2.1\u201353.8], <jats:italic>P<\/jats:italic> = 0.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In pediatric rheumatic conditions, vertebral fractures can be present prior to prolonged glucocorticoid exposure.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.20171","type":"journal-article","created":{"date-parts":[[2010,3,30]],"date-time":"2010-03-30T12:00:36Z","timestamp":1269950436000},"page":"516-526","source":"Crossref","is-referenced-by-count":123,"title":["Prevalent vertebral fractures among children initiating glucocorticoid therapy for the treatment of rheumatic disorders"],"prefix":"10.1002","volume":"62","author":[{"given":"A. 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