(A) Simple diagram showing mesenchymal stem cell (MSC) and hematopoietic stem cell (HSC) differentiation. In typically developing children, MSCs favor osteogenic differentiation due to adequate loading, nutrition, hormonal milieu, and growth. In children with cerebral palsy, MSCs likely favor adipogenic differentiation due to multiple and complex factors. (B) Diagram showing potential mechanisms of elevated bone marrow fat on skeletal metabolism in children with cerebral palsy. Dashed red line indicates a suppressive role. Solid blue line indicates a stimulating role.