What to Know About Childhood Osteoporosis

Juvenile osteoporosis weakens children’s bones and can result in long-term bone health problems. Addressing the underlying cause can help restore bone strength.

Osteoporosis in childhood, medically referred to as juvenile osteoporosis, is a condition that involves weak or fragile bones that are more susceptible to fractures. While osteoporosis is often associated with older adults, it can also affect children and adolescents, potentially leading to lifelong health challenges.

Here’s more about what causes juvenile osteoporosis, what symptoms to watch for, and what treatments may help.

What is osteoporosis in childhood?

Osteoporosis is a health condition that affects the bones. It involves a decrease in bone density and strength, which may make bones fragile and prone to fractures over time. Osteoporosis is called a “silent” bone disease because individuals may not realize they have it until they experience multiple fractures.

Osteoporosis most commonly affects women over age 50 years. This condition is relatively rare in children , and the exact number of kids and teens who have it is unknown . What experts do know is that juvenile osteoporosis can significantly affect a child’s growth and development and lead to issues with chronic pain , bone deformities, and an overall decrease in quality of life.

What are the symptoms of osteoporosis in childhood?

The signs and symptoms of juvenile osteoporosis can vary from child to child. That said, a common thread is frequent fractures. Children with this condition often experience two or more long bone ( femur , tibia , humerus , etc.) fractures by 10 years old and three or more long bone fractures by 19 years old.

Additional signs and symptoms may include:

• back, hip, or foot pain
• limping or trouble walking
• slowed growth
• a decrease in height
• posture changes or spinal changes
• fatigue or decreased activity

What causes osteoporosis in childhood?

Juvenile osteoporosis is typically caused by underlying medical conditions, such as hormonal imbalances, nutrition and metabolic disorders , or chronic illnesses that affect bone density. Additionally, certain medications — including prolonged use of corticosteroids — can contribute to the development of juvenile osteoporosis by impairing bone growth and mineralization .

Diseases that may affect bone mass include:

• celiac disease
• cerebral palsy
• cystic fibrosis
• eating disorders
• kidney disease

Medications that may affect bone mass include:

• seizure medications (anticonvulsants)
• corticosteroids
• cyclosporine
• immunosuppressants

Behaviors that may affect bone mineral density include:

• inactivity due to injury or disease
• nutritionally deficient diet, specifically low in calcium and vitamin D
• excessive exercise, particularly if it causes amenorrhea

In some cases, there is no known cause for the bone issues. When doctors cannot identify an underlying cause, it is referred to as idiopathic juvenile osteoporosis. This condition generally begins during periods of rapid growth, such as before puberty .

How is osteoporosis in childhood diagnosed?

Your child’s doctor will perform a physical examination and review their medical history to look for a family history of osteoporosis or other conditions that may contribute to bone health issues.

Bone density testing

Your doctor may use a dual-energy X-ray absorptiometry (DXA) scan to measure your child’s bone mineral density. This test is noninvasive and can help determine the strength of the bones and identify signs of osteoporosis.

Laboratory testing

Your doctor can order blood tests to check your child’s levels of calcium , vitamin D , and hormones that influence bone health. These tests can help identify metabolic, hormonal, or other disorders that contribute to osteoporosis.

Imaging studies

Your doctor may also order X-rays , magnetic resonance imaging (MRI) scans, or other imaging tests to assess your child’s bones, fractures, or other abnormalities.

What’s the treatment for osteoporosis in childhood?

Identifying the underlying cause of juvenile osteoporosis is key to treating it. While medications can strengthen bones and reduce fracture risk, addressing the root cause is essential to prevent ongoing bone density issues.

Treatment may include:

• medication changes, such as lowering dosages of drugs that contribute to bone health issues
• physical therapy to reduce the risk of falls and fractures
• lifestyle changes, like eating a well-balanced diet rich in vitamin D and calcium and performing weight-bearing exercises
• supplementation of vitamin D and calcium to protect bone health
• medications to manage pain or (in severe cases) to strengthen bones

Children with idiopathic osteoporosis may not need special treatment; this condition may go away on its own.

What’s the outlook for people with osteoporosis in childhood?

Early diagnosis is critical for effective treatment and management of juvenile osteoporosis. Since a peak bone mass is reached by age 30 years, if your bone mass is affected by juvenile osteoporosis, it may have effects that last into adulthood.

However, treating the underlying cause of juvenile osteoporosis can help preserve bone integrity and reduce the risk of developing osteoporosis later in life.

Frequently asked questions

Does juvenile osteoporosis go away?

Idiopathic juvenile osteoporosis may go away on its own . Osteoporosis caused by an underlying condition may improve or resolve once the underlying condition is treated.

How can you improve bone density in kids?

Preserving bone density can be helped by eating a diet rich in vitamin D and calcium, getting regular exercise , and monitoring health conditions that may lead to bone issues .

What exercises strengthen bones for kids?

Weight-bearing exercises (like walking) and resistance training (like lifting weights) may help improve bone density. Physical therapy can help restore function and strength after fractures.

Takeaway

Make an appointment with your pediatrician if your child has had multiple bone fractures or you have other concerns about their bone health.

Juvenile osteoporosis can affect growth and increase the risk of osteoporosis later in life. Early diagnosis and treatment are essential for restoring bone density and reducing fracture risk, ultimately ensuring long-term bone health.