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Feature Article

Osteoporosis in childhood: building better bone

Angela T Titmuss, Craig F Munns

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Abstract

Childhood osteoporosis can impact on development and function and can have manifestations into adult life. It can result from a genetic cause (primary) or be secondary to other medical disorders or treatments. Monitoring and maximising the bone health of all children is important, especially those with risk factors for osteoporosis.

Key Points

  • Bone health is an important issue for all children.
  • Osteogenesis imperfecta is the most common primary (genetic) cause of osteoporosis in children. Common secondary causes include glucocorticoid use, immobility due to neurological and muscular diseases, chronic inflammation and malabsorption.
  • Clinical criteria are the focus of the definition of osteoporosis in children, with bone fragility being demonstrated by clinical outcomes. The condition cannot be diagnosed purely on the basis of low bone mineral density.
  • Children with primary osteoporosis tend to present early in life with multiple fractures. Conversely, secondary osteoporosis in children is often asymptomatic, even when vertebral fractures are present.
  • Monitoring and maximising the bone health of all children is important, especially those with risk factors for osteoporosis.
  • In some patients, the use of bisphosphonates may be appropriate after other factors that affect bone health have been addressed.

    Picture credit: © Suzanne Tucker/Shutterstock. Model used for illustrative purposes only.

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