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Skeletal radiographs. (A) Skull films show no evidence of wormian bones. (B, C) Upper extremity and spine films suggest osteopenia. (D) Left-hand radiograph revealed second metacarpal cortical thickness measuring 0.5 mm prior to zoledronic acid. (E) Left-hand radiograph one year later showed second metacarpal cortical thickness of 1 mm.
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A radiographic skeletal survey suggested osteopenia but no wormian bones (Fig. 1). The second metacarpal cortical thickness measurement at 3 years (height age of 15 months) was 0.5 mm (mean cortical thickness for 1-year-old males is 1.46 mm with standard deviation of 0.30 mm, and for 2-year-old males is 1.85 mm with standard deviation of 0.39 mm) and, thus, also supported the qualitative assessment of low bone mass on plain radiographs (Fig. 1).
PMC4235665_02