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Osteogenesis Imperfecta

Osteogenesis imperfecta (OI) is a bone disorder that is passed from parents to children. It cannot be acquired; people with OI are born with it. It is also called brittle bone disease. Common issues with OI are breaking bones easily or not having the bones form correctly, leading to bone deformities.

Signs and symptoms vary from case to case and depend on what type of OI you have, which is determined based on how you inherit the disease. The types of OI include:

  • Type I – The most common and most mild form of the disease. About half of affected children have Type I OI.
  • Type II – This type of OI is the most severe and while it is not lethal upon birth, most babies will die within weeks of birth. Babies may be born with broken bones, underdeveloped lungs, and a softer than normal skull.
  • Type III – this is the most severe type for children who live past the first few weeks of birth. Expect legs and arms that are not as long as they should be, trouble breathing, and potential spine and rib fractures. There may also be issues swallowing or breathing.
  • Type IV – Symptoms range from mild to severe with Type IV. It may be detected at birth. The baby may not break any bones until they begin movement like crawling or walking. Babies with Type IV may also experience stunted growth and bone deformities in the arms or legs – or they may not.
  • Type V – Similar to Type IV. Common to have overgrowth of muscle in areas where there are bone fractures.
  • Type VI – This rare type is similar to Type IV.
  • Type VII – Similar to Type II or Type IV. May be shorter than normal and experience shorter than normal bones in the arms and legs.
  • Type VIII – Similar to Types II and III. May experience soft bones and growth issues.

Symptoms

Common symptoms of OI include:

  • Bone deformities
  • Bones that break easily
  • Curving in the spine
  • A barrel shaped chest
  • A triangular shape to the face
  • Muscle weakness
  • Loose joints
  • Hearing loss in young adulthood
  • Soft teeth
  • Easily bruising
  • Discoloration in the whites of the eyes and the teeth to a blue or grey

It’s important to remember that OI looks different in every child. OI can also look like other bone disorders. Make sure to see your physician for a diagnosis.

Causes & Risk Factors

OI is caused by a mutation, or change, in one of two genes. Both help form collagen, the connective tissue that helps hold the body together. This mutation is either passed on from your parents – one or both of them – or it may occur spontaneously. Either way, OI is always present at birth.

If you inherit a mutated gene for collagen production from both parents, the chances of having one of the more severe forms of OI increases. That’s why the only big risk factor for OI is a family history of OI. Couples who would like to start a family but have a history of OI may consider genetic testing first to assess the risk of OI.

Diagnosis & Complications

If your baby’s physician suspects that they have OI, they will ask you about your medical history, your pregnancy, your baby’s symptoms, and your family’s medical history. They will also examine your baby for any signs and symptoms of OI. In more mild cases, it can be difficult to diagnose OI in infancy.

Your physician will probably refer you to a specialist, like an orthopaedic doctor or a geneticist. They may run certain tests to confirm a diagnosis of OI. These include X-rays, lab tests, a bone biopsy, and genetic testing.

Complications of OI include kidney stones, hearing loss, joint issues, vision loss, heart problems, and respiratory infections.

Treatment & Management

The main goal of treatment is to prevent bone fractures and deformities. Treatment options may include bone-strengthening medicines (bisphosphonates), metal rods placement, care for bone breaks, devices that assist with mobility, and physical and occupational therapy.

 
 
 

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