There is no universally accepted definition of osteoporosis in children. To determine whether an adult has osteopenia or osteoporosis, a bone density measurement is usually performed. Carrying out this test is not routinely recommended in children. Only in certain rare cases will such an examination be requested by the physician, for example when a child has sustained multiple fractures or fractures at sites that are unusual for young ages, such as the hip or a vertebra. Bone density measurement may also be requested in children with problems associated with low bone mass.

Osteopenia and osteoporosis are defined differently in children. Bone density is considered low when a child has a Z-score equal to or lower than -2 on bone density measurement.

Low bone density or bone mass in children is often due to genetic factors, but it may also occur as a result of certain diseases or the use of medication for other conditions. In some cases, the causes remain unknown.

Some conditions that may lead to pathological fractures or low bone mass are listed below.

Osteogenesis Imperfecta (Lobstein Syndrome)

This is a condition different from osteoporosis, but it also leads to bone fragility. It is a genetic disorder caused by abnormal structural formation of collagen. It is inherited in an autosomal dominant manner. It has 8 types, the most common being Type I, which is characterized by hearing loss at a young age and blue sclerae (instead of white).

Idiopathic Juvenile Osteoporosis

This is a form of osteoporosis of unknown cause that affects children aged 1 to 13 years and is characterized by fractures in the bones of the lower limbs and the spine. Its treatment includes calcium and vitamin D supplements, along with great care by parents to avoid accidents. Fortunately, it usually resolves during adolescence. It is not known whether it affects bone health later in life.

Corticosteroid-Induced Osteoporosis (cortisone and its derivatives)

The use of corticosteroid medications or related agents in any form (tablets, injections, inhaled formulations) and over a prolonged period may delay bone development in children. This increases the likelihood of low bone mass later on. Corticosteroids are used in the treatment of diseases such as arthritis, asthma, and Crohn’s disease.

If your child needs to take corticosteroids for any reason, speak with your pediatrician about the necessary measures you should take to protect their bones.

There are no medications, other than calcium and vitamin D supplements, that are approved for the treatment of osteoporosis in children.

Once again, the importance of a balanced diet rich in vitamin D and calcium, as well as the necessity of physical activity for a strong skeleton, should be emphasized.