What is osteoporosis?
Osteoporosis is a condition in which the bones are weak and likely to fracture. Although
much more common in older adults, especially women during and after menopause, osteoporosis
can also occur during childhood. The definition of diagnosis of osteoporosis in childhood
is different than in adults and is based on a history of fractures AND low bone mineral
density on DXA bone density test. Most often, osteoporosis during childhood is caused
by an underlying medical condition (called secondary osteoporosis) or a genetic disorder
(such as osteogenesis imperfecta). Sometimes, no cause can be found and the disease
is categorized as a rare form of osteoporosis, called idiopathic juvenile osteoporosis
What causes osteoporosis in children?
In children, the following medical conditions or medications can lead to osteoporosis.
These are caused by an underlying medical condition:
Chronic inflammatory disease like Crohn's disease or juvenile arthritis
Liver disease like biliary atresia
Metabolic conditions like homocystinuria or lysosomal disease
Type 1 diabetes
Osteoporosis can also be caused by the following medications:
Excessive inactivity or immobility
Dietary calcium and vitamin D deficiency
Excessive exercising leading to energy imbalance and weight loss
What are the symptoms of osteoporosis in children?
You should be concerned that your child might have osteoporosis if he or she has had
multiple fractures or any fracture that occurred in the absence of trauma (for example,
tripping over a curb and breaking a leg).
How is juvenile osteoporosis diagnosed?
The diagnosis of osteoporosis in children requires a history of fractures and in most
cases a finding of low bone mineral density on a DXA scan.
Review of medical history, medications, and family medical history
Skeletal X-rays. A diagnostic test that uses invisible electromagnetic energy beams to produce images
of internal tissues, bones, and organs onto film.
DXA scan. A diagnostic procedure to determine bone mineral density
Blood and urine tests. Tests to measure calcium, phosphorus, vitamin D and hormones.
Treatment for osteoporosis in children
All children with osteoporosis will be evaluated to make sure they are receiving enough
calcium and vitamin D in their diet and to be sure they are getting enough weight
bearing exercise. In most cases, children with osteoporosis will be treated with a
type of medication called bisphosphonates. These medications work to improve bone
density and thereby strengthen bones.
Nutrition evaluation and supplementation with calcium and vitamin D, if necessary
Physical therapy evaluation and recommendation for weight bearing exercises such as
walking or time in a stander
Bisphosphonates. Names of bisphosphonates commonly include "zoledronic acid," "pamidronate,"
Online Medical Reviewers:
- David Weber, MD, MSCE
- MMI board-certified, academically affiliated clinician
- Turley, Ray, BSN, MSN