A child with dermatomyositis, calcinosis universalis, and osteoporosis died as a result of a physical-therapy-produced fracture and subsequent fat embolism syndrome. The possible etiologic relationship of "collagen diseases" and the fat embolism syndrome is considered, and it is suggested that osteoporosis, and not these diseases per se, is the predisposing factor. It is emphasized that the vigor with which physical therapy is applied must be curtailed in patients with significant osteoporosis.
Shulman ST, Grossman BJ. Fat Embolism in ChildhoodReview With Report of a Fatal Case Related to Physical Therapy in a Child With Dermatomyositis. Am J Dis Child. 1970;120(5):480–484. doi:10.1001/archpedi.1970.02100100144022