Metabolic Bone Clinic

Metabolic Bone Clinic

The Metabolic Bone Clinic at Cincinnati Children's Hospital Medical Center strives to provide a comprehensive care approach to children and young adults with skeletal fragility and/or disorders of bone metabolism. The foundation for skeletal health is achieved during the pediatric years and some children are born with fragile bones whereas others are at risk for acquiring deficits in skeletal health due to other medical conditions they face.

Our goal is to provide ongoing, compassionate care for your child, promoting their health and well-being and preventing the consequences of bone disease including deformity, pain, growth delay, fractures or other bone-related disabilities.

How are we different?

Our team has a deep understanding of pediatric bone health including genetic predisposition, nutritional factors, impact of growth and puberty on skeletal health, and an awareness of the impact of physical activity on bone formation. Our physicians are also Certified Clinical Densitometrists meaning they have additional training in reading pediatric bone density (DXA scans). For patients with undiagnosed disorders of skeletal fragility or impaired bone metabolism, we partner with clinical and molecular geneticists within the Department of Human Genetics at Cincinnati Children's Hospital Medical Center for further investigation.

We have extensive experience treating skeletal fragility with bisphosphonate infusions on a compassionate care basis. In addition, our expertise extends to newer treatments with burosumab (Crysvita®), denosumab (Xgeva®, Prolia®), asfotase alfa (Strensiq®) and recombinant human parathyroid hormone (Forteo®, Natpara®) to treat rare disorders of bone metabolism.

Conditions We Treat:

  • Osteogenesis Imperfecta and other primary skeletal fragility disorders
  • Osteoporosis secondary to chronic medical conditions or treatments
  • Vitamin D Deficient Rickets
  • Hypophosphatemic Rickets
  • Calcium Disorders
  • Phosphate disorders
  • Parathyroid disorders
  • Hypophosphatasia
  • Recurrent Fractures

Treatment Approach:

Our team provides comprehensive care for children and young adults with metabolic bone disease at Cincinnati Children’s Hospital Medical Center. Patients are seen by a pediatric endocrinologist. Depending on need, care is coordinated with a physical therapist who has expertise in skeletal fragility as well as clinical geneticists. The initial work up may include:

  • Laboratory evaluation to identify nutritional, hormonal, or metabolic abnormalities
  • Bone mineral density (BMD) assessment using dual energy X-ray absorptiometry (DXA) scans
  • Treatment with IV or oral bisphosphonates and other bone-promoting agents
  • Comprehensive genetic counseling and evaluation available for congenital and familial causes of metabolic bone disease
  • Dentistry consultations available for patients with bone disorders including those receiving bisphosphonate treatment
  • Potential for enrollment in research studies
  • Children with osteoporosis or at high risk for skeletal fragility may be started on bisphosphonate infusions. While we often give the first infusion inpatient with an overnight observation period, subsequent infusions can be scheduled in our outpatient infusion center or through home health. Our nurse coordinator helps schedule all infusions as well as follow up appointments and imaging.

    What doctors will I see in this clinic?

    What other healthcare providers might I see in this clinic?

    • Karla Johnson, RN Nurse Coordinator
    • Mary Sue Owens, RN Clinical Nurse
    • Pediatric Endocrinology fellow
    • Pediatric resident
    • Dietician

    What other specialists might I expect to help in my care?

    How do I refer a patient to Metabolic Bone Clinic?

    • Call 513-636-3200 and request an appointment in Metabolic Bone Clinic.

    Research to Advance Clinical Care of Patients with Metabolic Bone Disease:

    Cerebral Palsy Bone Health Study for Children 5 to 10 Years Old

    Skeletal Health and Bone Marrow Composition in Transgender Youth

    X-linked Hypophosphatemia Disease Monitoring Study

    Autosomal Dominant Hypocalcemia Types 1 and 2 (ADH1/2) Disease Monitoring Study

    Contact Us

    Questions about this clinic?

    For more information, contact:
    Pamela Burwinkel, RN
    Clinic coordinator
    1-800-344-2462, ext. 64744