But early changes can be detected by screening with DXA scans, a totally non-invasive procedure. In the Leeds CF Unity, all patients are offered DXA scanning, treatment if appropriate, and follow-up scans every two years. It is disappointing to us that not all patients have taken up this offer. Those with osteopenia or osteoporosis need further investigation to exclude causes for this other than CF itself. Any such cause will of course be treated.
Prevention is best but some promising treatments for established osteoporosis are available.
They need to be properly assessed in CF care and these studies are now being done in several CF centres. Episodes of joint pain are well recognised in CF, usually starting after ten years of age, and occurring in about five to ten percent of patients. They were first described in 1979 in five children under ten years of age who suffered recurrent episodes of joint stiffness, swelling and pain. The commonest form of joint pain in CF is an arthritis, which mostly affects the large joints, for example the knee, ankle, wrist, elbow and shoulder. This is sometimes referred to as CF associated arthritis.