A 3-year-old boy is brought to the physician because of arm pain following a fall that took place 5 hours ago. According to his mother, the boy was running in the yard when he fell and injured his right arm. The boy is crying and clutching his arm. During the past year, he has been brought in 4 other times for extremity pain following falls, all of which have been diagnosed as long bone fractures. His right forearm is diffusely erythematous. The patient withdraws and yells when his forearm is touched. His left arm has two small ecchymotic regions overlying the elbow and wrist. A photograph of his eyes is shown. 1ec160b_3a5f_7b1a_9249_b532365e1285_MD0001_00 This patient's condition is most likely associated with impairment of which of the following processes?

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Eductional Objective: Osteogenesis imperfecta results from defective synthesis of type 1 collagen by osteoblasts.  Clinical findings include a history of fractures after only minimal trauma, blue sclerae, and small, malformed teeth.  In most patients, osteogenesis imperfecta is transmitted by autosomal dominant inheritance.

A 3-Year-Old Boy Is Brought to the Physician Because of Arm