Pediatrician
December 1, 2015

For many pediatric endocrine issues, it’s fairly easy to figure out which subspecialty is the best one to take a referral—for example, diabetes, thyroid disorders, and precocious puberty have their own well-defined teams of experts. But bone health remains an amorphous area, says Hopkins pediatric endocrinologist Janet Crane, with patients often shuffled from physician to physician.

“Medicine simply doesn’t know what to do with these kids,” she says. “I see this as a huge target for improvement.”

To help solve this gap, Crane recently began a bone health clinic that operates out of a local community hospital, Greater Baltimore Medical Center (GBMC). Though she currently sees patients every second and fourth Wednesday of the month, she’s expecting the clinic to have more availability soon, with plans for her colleague, pediatric endocrinologist Dominique Long, to join her in the future.

The outreach clinic, which offers patients a full bone health assessment at one visit, will also allow Crane and Long to identify more children with potential bone health problems. The most recent consensus statement from the International Society for Clinical Densitometry recommends screening of not only children with a chronic medical condition known to affect bone health, but also otherwise normal, healthy children who have sustained multiple fractures. Another recent study also found that children with a forearm fracture after mild trauma may have subtle micro-architectural differences that predispose them to low bone strength which may also warrant further work-up (J Bone Miner Res. 2014 Mar;29(3):590-9).

“These recent publications suggest we may be missing many children out in the community that may benefit from interventions to promote bone health,” says Crane.“Therefore, the Bone Health Clinic at GBMC is the first step to improving access to care.”

For more information, call 410-955-6463.