Topic Resources
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Bone disorders can be caused by injury, infection, or cancer, be inherited, occur as part of a child’s growth, or occur for no known reason.
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Some bone disorders can cause pain and difficulty walking, whereas others cause no symptoms.
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Doctors base the diagnosis on a thorough history, close observation and examination, and the selective use of x-rays or magnetic resonance imaging (MRI).
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Treatment depends on the disorder.
Children’s bones grow continually and reshape (remodel) themselves extensively. Growth proceeds from a vulnerable part of the bone called the growth plate. In remodeling, old bone tissue is gradually replaced by new bone tissue. Many bone disorders come from the changes that occur in a growing child’s musculoskeletal system. These disorders may get better or worsen as the child grows. Other bone disorders may be inherited or occur in childhood for no known reason.
Growth plates
People think of bones as solid objects. But bones need to grow
along with the rest of the child's body. Children's bones grow from soft
areas of cartilage near the ends of bones. These areas are called
growth plates. When children have finished growing, growth plates become
solid bone. After growth plates become solid, bones do not grow in
length. That is why people do not become taller after a certain point in
late adolescence. Although bones repair themselves, such as after an
injury, that repair does not involve the growth plates.
Osteochondrosis refers to a group of disorders of the
growth plate that occur when the child is growing rapidly. Doctors are
not sure what causes osteochondrosis, but the disorders do seem to run
in families. Osteochondroses include Köhler bone disease, Legg-Calvé-Perthes disease, Osgood-Schlatter disease, and Scheuermann disease.
Locating the Growth Plates
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Growth plates (indicated by the pink lines) are areas of cartilage near the ends of long bones, such as the arm and leg bones. They enable bones to lengthen until children reach their full height. 
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Causes
Bone disorders in children can result from causes that affect people of all ages, including injury, infection (osteomyelitis),
or cancer. Causes of bone disorders that affect mainly children
typically involve the gradual misalignment of bones, which is caused by
forces exerted on the growth plates as children are developing. A poor
blood supply can also damage the growth plate, as can separation from
the rest of the bone or even minor misalignment. Damage to the growth
plate suppresses the growth of bones, distorts the joint, and can cause
long-lasting joint damage (arthritis).
Certain rare connective tissue disorders can also affect the bones. They include Marfan syndrome, osteogenesis imperfecta, and osteochondrodysplasias. Osteopetroses are other rare hereditary disorders that increase the density of bones, cause bones to grow abnormally, or both.
Symptoms
Bone disorders sometimes cause painless deformities. Some deformities may affect a child’s ability to walk or use the limbs.
Diagnosis
Treatment
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Depends on the disorder
Treatment of bone disorders varies depending on the condition.
Children may outgrow some disorders. However, others may require bracing
or surgical intervention.
If the growth plate becomes damaged, surgery may help. Accurately
realigning separated or misaligned ends of the growth plate may
surgically restore normal bone growth. By decreasing the irritation
caused by misalignment, surgery may prevent the development of arthritis
in the joint.
If a bone disorder causes a physical deformity, children may
become anxious or depressed. Some treatments for bone disorders may also
be psychologically difficult to accept. For example, adolescents may be
reluctant to wear a back brace for treatment of scoliosis
because doing so makes them appear different from their peers.
Professional counseling may relieve anxiety or depression.
Counseling may also help children go through with difficult treatments.
Counseling may also help children go through with difficult treatments.
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