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placeholder7The regional metabolic bone service is run by Dr Poonam Dharmaraj, Dr Renuka Ramakrishnan and Endocrine Nurse Specialist Lynne Hatchard at Alder Hey Children’s Hospital.

The service sees new and follow-up patients with disorders of calcium, phosphate and bone metabolism and includes the following patient groups:

  • Osteogenesis Imperfecta (OI)
  • Osteoporosis (primary and secondary)
  • Osteoporosis of immobility or associated with syndromes
  • Hereditary Hypophosphataemic rickets
  • Vitamin D deficiency
  • Skeletal dysplasias
  • Fibrous dysplasia
  • Disorders of calcium (pseudohypoparathyroidism, hypoparathyroidism, calcium sensing receptor mutations)
  • Hypophosphatasia
  • Metabolic bone disease of prematurity
  • Other disorders of phosphate metabolism

The team work closely with Dr Caren Landes (radiologist with expertise in skeletal dysplasias and interpretation of DEXA and QCT scans), clinical genetics colleagues and orthopaedic colleagues (particularly Mr Leroy James who has a special interest in surgical management of OI).

The management of severe, complex and atypical OI is nationally commissioned to 4 centres and we work closely with Sheffield Children’s Hospital metabolic bone team who are a supra-regional centre.

This involves 2 multidisciplinary clinics per year in which the Sheffield team come to Liverpool to see patients. The management of newborns with severe OI is also jointly with the Sheffield team.

The Alder Hey service is happy to receive referrals from Merseyside, Cheshire and North Wales and already collaborates closely with Paediatricians in these areas.

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