BIOMARKERS OF BONE REMODELING AND GROWTH FACTORS IN DIAGNOSIS OF STAGES OF FEMORAL OSTEONECROSIS IN CHILDREN

A.V. Sertakova, I.A. Norkin, S.A. Rubashkin
Saratov Research and Development Institute of Traumatology and Chernyshevskogo str., 148, Saratov, Russian Federation, 410002

Introduction. Legg–Calve–Perthes disease or osteonecrosis of the femoral head with the occurrence rate of 25–30% takes the leading place among diseases of the musculoskeletal system in children. Nowadays there are some diagnostic methods to determine the stage and degree of the bone damage: X-ray, CT and MRI, but none of the existing methods can not detect early changes in the bone tissue. The aim of the study. To determine the degree of the deterioration in the bone remodeling on the base of MRI data, as well as an array special biomarkers in children with different stages of osteonecrosis of the femoral head. Methods. The study of biomarkers of the bone remodeling (C-terminal telopeptide of type I collagen, pyridinoline, type 1 procollagen carboxy-terminal extension peptide) and growth factors (VEGF, FGF) by enzyme immunoassay in the serum of children aged 4–9 years, suffered from Legg-Calve-Perthes disease, and children without hip disease. Results. The alteration of the levels of biomarkers of the bone tissue remodeling and growth factors was shown to appear at the early preclinical stage of the disease and correlate with the severity of the pathological process, confirmed by X-ray and MRI. Conclusion. Developed classification concept permits to diagnose minimal changes in the processes of the bone remodeling that opens broad opportunities for the diagnosis of preclinical stages of osteonecrosis of the femoral head of different types, especially osteochondropathy.
Keywords: 
biomarkers of the bone remodeling, growth factors, osteonecrosis of the femoral head, Legg–Calve–Perthes disease, children