Osteoporosis is a condition in which a decrease in the density of bones weakens the bones, making breaks (fractures) likely.
Osteoporosis in children may be primary or secondary. Primary osteoporosis occurs spontaneously. Secondary osteoporosis results from chronic illnesses, medications, excessive inactivity or immobility, or poor nutrition.
Idiopathic juvenile osteoporosis is a rare form of osteoporosis that is diagnosed when a child with normal hormone function has fragility fractures and low bone density but does not have an identifiable cause.
Symptoms of Osteoporosis in Children
Symptoms in children include a generally increased risk of fractures, especially of the long bones in the legs and arms and of the spine. Fragility fractures are fractures that result from a relatively minor strain or fall, such as a fall from a standing height or less, including a fall out of bed, that normally would not cause a fracture in a healthy bone.
Children may also have bone pain or back pain. Affected children may also not be able to move as much or be as physically active as children who do not have osteoporosis.
Diagnosis of Osteoporosis in Children
Dual-energy x-ray absorptiometry (DXA) scan
History of fractures
Doctors do a DXA scan to determine whether a child has low bone density. The DXA scan takes high-energy and low-energy x-rays of the spine and hip, which are the sites at which major fractures are likely to occur. The difference between the high- and low-energy x-ray readings allows doctors to calculate bone density. The result is reported as a Z-score, which compares the child's bone density to the density of a healthy child of the same sex and age. The lower the bone density, the lower the Z-score. A Z-score of –2.0 or lower indicates low bone density.
Doctors also take into account the child's fracture history. For example, a child who has had 3 or more arm or leg bone fractures by age 19 may have osteoporosis.
Treatment of Osteoporosis in Children
Nutrition and supplements
Physical activity
Bisphosphonates
Treatment in children usually begins with nutrition. Children need to get enough calcium and vitamin D in their diet (see table Treatment in children usually begins with nutrition. Children need to get enough calcium and vitamin D in their diet (see tableAmount of Calcium in Some Foods). Children who do not get enough of these nutrients in their diet may be given supplements.
Physical activity and weight-bearing exercise (such as walking) help strengthen bones and increase bone density.
Treatment also includes medications called bisphosphonates. These medications reduce bone loss and reduce the risk of fractures.
