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Hi there,

I am just after some pointers about a case. Any suggestions or comments would be appreciated.

I have a young client (5yo) who attended for opinion on “flat feet, funny ankles and knocked knees”, no pain. Was a W-sitter, and parents have a very similar foot type.
I initially saw the client 5 months ago and at review today I was happy with how their feet and gait are developing without orthotic intervention.

Their mother asked me a question that I thought I would put out there as I don’t what to have given her mis-information…

She asked me what the paediatrician meant those years ago when he said that her child had “spongy bones,” and if this would continue on forever.

Client was born at 30 weeks. Developmentally, Mum reports that they have had several check-ups but that all went well.

As far as I could assume this comment would have related to being born prematurely, and the ongoing ossification of bones up until skeletal maturity. I explained some of the ossification sites of the feet as examples, showed pictures of toddler vs teen/adult x-rays and put this back into general terms of being born prematurely.

I spoke to a dietitian at work, and have some general information on Calcium (recommended intakes, examples of foods rich in calcium etc) which I will send out to the mother.

Is anyone familiar with any further advice?
Are kids who are born prematurely more susceptible to rickets, osteoporosis, fractures…?
Should weight bearing activity be increased to help stimulate bone production?

Thanks!

 

Basically we are all made up of compact bone and spongy bone;the compact bone (cortical) is the outer layer and contains the yellow marrow and the spongy bone (cancellous)contains the red marrow. Spongy bone is found at the ends of the long bones of the body. It is nothing unusual. Hope that helps.

 

I suspect she has misunderstood something the paediatrician said. As David said, 'spongy bone' is a normal part of each bone and I know of no bone condition that gets the lay label of 'spongy bones'.

 

Never underestimate the ability of patients to misunderstand, or even reverse, the meaning of things that you, or any other health professional, says to them.

I would assume that "spongy" bones meant pre-ossification. So, I would reassure her that all children have spongy bones.

If you've ever seen a child squash their finger in a door, you know just how spongy their bones really are.