Juvenile osteoporosis
Overview
Osteoporosis (progressive bone loss) that occurs in children. Osteoporosis in children can be caused by certain medical conditions (e.g. diabetes, malabsorption syndromes, kidney disease, hyperthyroidism), certain medications (e.g. corticosteroids, anticonvulsants), prolonged immobility or sometimes for no detectable reason (idiopathic).
Symptoms
- Reduced bone density
- Fractures
- Curved spine
- Sunken chest
- Limp
- Lower back pain
- Hip pain
- Leg pain
- Difficulty walking
- Loss of height
- Asymptomatic
Causes
In children, the following causes may be attributed to the different forms of osteoporosis:
- secondary osteoporosis disorders(caused by an underlying medical condition)
- juvenile arthritis
- diabetes mellitus
- osteogenesis imperfecta
- homocystinuria
- hyperthyroidism
- hyperparathyroidism
- Cushing's syndrome
- malabsorption syndromes
- anorexia nervosa
- kidney disease
- medications, including the following: anti-convulsants (for seizures) , corticosteroids , immunosuppressive medications , lifestyle , excessive inactivity/immobility , dietary calcium and vitamin D deficiency , excessive exercising , amenorrhea
Diagnosis
Diagnosis of juvenile osteoporosis is often not made until the child has a broken bone. In addition to a complete medical history and physical examination, diagnostic procedures for juvenile osteoporosis may include:
- family medical history
- skeletal x-rays - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
- bone density test - a diagnostic procedure to determine bone mineral content and skeletal changes, such as bone loss.
- blood tests (to measure serum calcium and potassium levels)
Prognosis
Most children with IJO experience a complete recovery of bone tissue. Although growth may be somewhat impaired during the acute phase of the disorder, normal growth resumes - and catch-up growth often occurs - afterward. Unfortunately, in some cases, IJO can result in permanent disability such as curvature of the upper spine (kyphoscoliosis) or a collapse of the rib cage.
Treatment
There is no established medical or surgical therapy for juvenile osteoporosis, and, in some cases, there may be no need for treatment because the condition usually goes away spontaneously. However, early diagnosis of juvenile osteoporosis is important so that steps can be taken to protect the child's spine and other bones from fracture until remission occurs. These steps may include physical therapy, using crutches, avoiding unsafe weight-bearing activities, and other supportive care. A well-balanced diet rich in calcium and vitamin D is also important. In severe, long-lasting cases of juvenile osteoporosis, some medications called bisphosphonates, approved by the Food and Drug Administration for the treatment of osteoporosis in adults, have been given to children experimentally.