Juvenile Osteoporosis

What is juvenile osteoporosis?

Osteoporosis is a condition where the bones are thinner than normal. It’s a condition that gets worse over time. This means that bones get thinner over time, or don’t grow as they should. The bones are then weaker and at higher risk of breaking. The condition is much more common in older adults. But it can also occur during childhood. In children, it’s called juvenile osteoporosis.

What causes juvenile osteoporosis?

It’s most often caused by another health condition or it could be part of a genetic disorder. This is known as secondary osteoporosis. Some medicines may cause it. In some cases, no cause can be found. This is known as a rare form of osteoporosis called idiopathic juvenile osteoporosis (IJO).

Secondary osteoporosis can be caused by health conditions such as:

• Juvenile arthritis
• Diabetes mellitus
• Osteogenesis imperfecta
• Homocystinuria
• Hyperthyroidism
• Hyperparathyroidism
• Cushing syndrome
• Malabsorption syndromes
• Anorexia nervosa
• Kidney disease
• Cystic fibrosis
• Sickle cell anemia
• Turner syndrome

Medicines that can cause osteoporosis include:

• Anticonvulsants
• Corticosteroids
• Immunosuppressive medicines
• Anticancer medicines

Other problems that may cause osteoporosis include:

• Extreme lack of activity or immobility
• Lack of calcium and vitamin D in the diet
• Extreme exercising that leads to loss of menstrual periods (amenorrhea)     

Who is at risk for juvenile osteoporosis?

A child is more at risk for juvenile osteoporosis if he or she has any of these:

• High doses of corticosteroids
• Family history of the condition
• Lack of physical activity
• History of certain chronic health conditions

What are the symptoms of juvenile osteoporosis?

The condition may not cause any symptoms. But a child with juvenile osteoporosis may have a history of broken bones. 

A child with the rare idiopathic juvenile osteoporosis (IJO) may have symptoms such as:

• Lower back, hip, and foot pain
• Hump of the spine (kyphosis)
• Sunken chest
• A limp

The symptoms of juvenile osteoporosis may seem like other bone disorders or health problems. Make sure your child sees his or her healthcare provider for a diagnosis.                    

How is juvenile osteoporosis diagnosed?

Diagnosis of juvenile osteoporosis is often not made until the child has a broken bone. The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask about your family’s health history. He or she will give your child a physical exam. Your child may also have tests, such as:                                                                                                                                                           

• X-rays. This test uses a small amount of radiation to create images of tissues, bones, and organs. The bones may be X-rayed to see if they are thinned.
• Bone density test. This test is done to look at bone mineral content and bone changes, such as bone loss. But normal test results for children can vary widely. It depends on what machine is used and how much experience the clinic has. 
• Blood tests. These are done to measure calcium and potassium levels in the blood.

How is juvenile osteoporosis treated?

For secondary osteoporosis, the cause of the disease may be treated. IJO often gets better on its own. In the meantime, it’s important to encourage healthy behaviors during a child's bone-building years. These may include:

• Keeping a healthy body weight
• Doing walking and other weight-bearing exercises
• Reducing caffeine in his or her diet, such as from soda
• Getting enough calcium and vitamin D through food, drinks, and supplements
• Cutting back use of certain medicines such as steroids for chronic conditions, if possible

Other treatment for IJO may include:

• Protecting the spine and other bones from breaks
• Physical therapy
• Medicines to manage symptoms

What are possible complications of juvenile osteoporosis?

Untreated, the condition can lead to:

• Frequent broken bones
• Impaired growth
• Curvature of the upper spine
• Collapse of the rib cage

Can osteoporosis be prevented?

In some cases, osteoporosis in a child can be prevented by:

• Keeping a healthy body weight
• Doing walking and other weight-bearing exercises
• Reducing caffeine in his or her diet, such as from soda
• Getting enough calcium and vitamin D through food, drinks, and supplements

Living with juvenile osteoporosis

Managing juvenile osteoporosis is important for your child's bone health. Help your child adopt a healthy lifestyle that includes:

• Keeping a healthy body weight
• Doing walking and other weight-bearing exercises
• Reducing caffeine in his or her diet, such as from soda
• Getting enough calcium and vitamin D through food, drinks, and supplements

Work with your child's healthcare providers to create an ongoing plan to manage your child’s condition.

When should I call my child's healthcare provider?

Talk with your child's healthcare provider about ways to prevent osteoporosis if your child:

• Has a chronic disease
• Is on medicines that increases his or her risk for osteoporosis

Key points about juvenile osteoporosis

• Juvenile osteoporosis is a condition where the bones are thinner than normal. Bones get thinner over time, or don’t grow as they should. The bones are then weaker and at higher risk of breaking.
• It’s most often caused by another health condition or it can be part of a genetic disorder. This is known as secondary osteoporosis. Some medicines may cause it. In some cases, no cause can be found. This is known as idiopathic juvenile osteoporosis (IJO).
• The condition may not cause any symptoms. But a child with juvenile osteoporosis may have a history of broken bones. A child with IJO may also have lower back, hip, and foot pain, and other symptoms.
• Treatment may include weight-bearing exercise, changes to a child’s diet, and calcium supplements.
• Untreated, the condition can lead to broken bones and impaired growth.

Next steps

Tips to help you get the most from a visit to your child’s health care provider:

• Before your visit, write down questions you want answered.
• At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you for your child.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.