{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:39:46Z","timestamp":1791308386702,"version":"4.3.1"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,12,28]],"date-time":"2011-12-28T00:00:00Z","timestamp":1325030400000},"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; Research"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the frequency of incident vertebral fractures (IVF) 12 months after glucocorticoid (GC) initiation in children with rheumatic diseases and to identify children at higher risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children with rheumatic diseases initiating GC were enrolled in a prospective observational study. Annual spine radiographs were evaluated using the Genant semiquantitative method. Spine areal bone mineral density (aBMD) was measured every 6 months. Clinical features, including cumulative GC dose, back pain, disease and physical activity, calcium and vitamin D intake, and spine aBMD Z scores, were analyzed for association with IVF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven (6%) of 118 children (95% confidence interval 2.9\u201311.7%) had IVF. Their diagnoses were: juvenile dermatomyositis (n = 2), systemic lupus erythematosus (n = 3), systemic vasculitis (n = 1), and mixed connective tissue disease (n = 1). One child was omitted from the analyses after 4 months because of osteoporosis treatment for symptomatic IVF. Children with IVF received on average 50% more GC than those without (<jats:italic>P<\/jats:italic> = 0.030), had a greater increase in body mass index (BMI) at 6 months (<jats:italic>P<\/jats:italic> = 0.010), and had greater decrements in spine aBMD Z scores in the first 6 months (<jats:italic>P<\/jats:italic> = 0.048). Four (67%) of 6 children with IVF and data to 12 months had spine aBMD Z scores less than \u22122.0 at 12 months compared to 16% of children without IVF (<jats:italic>P<\/jats:italic> = 0.011).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The incidence of VF 12 months following GC initiation was 6%; most children were asymptomatic. Children with IVF received more GC, had greater increases in BMI, and had greater declines in spine aBMD Z scores in the first 6 months.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.20589","type":"journal-article","created":{"date-parts":[[2011,9,1]],"date-time":"2011-09-01T01:30:31Z","timestamp":1314840631000},"page":"122-131","source":"Crossref","is-referenced-by-count":122,"title":["Incident vertebral fractures among children with rheumatic disorders 12 months after glucocorticoid initiation: A national observational 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