Osteoporosis is a condition that weakens your bones, making fractures more likely. It’s most common later in life, especially in women after menopause.
But it’s possible for children and teens to develop juvenile osteoporosis. This most often happens in children between ages 8 and 14. It sometimes develops in younger children during growth spurts.
It’s a serious problem, because it strikes when a child is still building up his bone strength. You build about 90% of your bone mass by the time you're 18 to 20. Losing bone mass during prime bone-building years can put someone at risk for complications such as fractures.
There are two kinds of juvenile osteoporosis: secondary and idiopathic.
Secondary osteoporosis means that another medical condition is to blame. This is by far the most common kind of juvenile osteoporosis. Some of the diseases and causes that can lead to osteoporosis in children include:
- Juvenile arthritis
- Cystic fibrosis
- Celiac disease
- Osteogenesis imperfecta ("brittle bone disease")
- Homocystinuria (a genetic metabolic disorder)
- Cushing's syndrome
- Malabsorption syndromes
- Anorexia nervosa or other eating disorders
- Kidney disease
Sometimes, juvenile osteoporosis is a direct result of disease itself. For example, with rheumatoid arthritis, children may have lower than expected bone mass, especially near arthritic joints.
The so-called female athlete triad can also lead to osteoporosis in young women. It’s a syndrome of three conditions that include lack of energy caused by poor eating habits and missed periods.
Certain drugs can also lead to juvenile osteoporosis. These can include chemotherapy for cancer, anticonvulsant medicines for seizures, or steroids for arthritis. If your child has one of these conditions, talk to his doctor about checking on his bone density.
Idiopathic osteoporosis means that doctors don’t know what caused the disease. This type of juvenile osteoporosis is much less common. It seems to be more common in boys than in girls. It usually starts just before puberty. The child’s bone density may mostly recover during puberty, but still not quite be normal when bone mass peaks as an adult.
The signs and symptoms of juvenile osteoporosis include:
- Pain in the lower back, hips, knees, ankles, and feet
- Trouble with walking
- Fractures in the legs, ankles, or feet
Juvenile osteoporosis is hard to define. Bone density scans are the most accurate way to detect lowered bone mass early on, but they need to be interpreted carefully to make a clear diagnosis in children.
Instead, doctors usually diagnose juvenile when there are signs that a child has a fragile skeleton. This might show up when a child's bone breaks without something like a bad fall or other trauma, and the child has a low bone mineral density score.
Your child’s doctor will make recommendations based on the cause of your child’s juvenile osteoporosis. If another disease is to blame, she’ll treat it. If a medication is responsible, your child may be able to take a different medicine or a lower dose.
None of the osteoporosis drugs that adults can take are approved for use in children.
It’s very important to protect your child's bones from fracture. He may need to use crutches or other supports. He may also need to avoid types of exercise, such as contact sports, that could cause a fracture. Your doctor can tell you what’s OK.
All children, including those with juvenile osteoporosis, need a lifestyle that helps build healthy bones. This includes a diet rich in calcium, vitamin D, and protein, and as much safe physical activity as possible. It's best to avoid caffeine. Many experts also suggest that children with juvenile osteoporosis get bone density tests at least every other year into adulthood.