Identification, Prevention and Treatment of Children with Decreased Bone Density

Osteoporosis in children is the presence of low bone mineral content or decreased bone mineral density with a significant fracture history. The future economic consequences and quality of life issues associated with osteoporosis are considerable, justifying this skeletal disorder as a public health concern. Accrual of bone mass begins in-utero and extends into early adulthood. The amount of bone accretion in childhood and early adulthood has been significantly related to bone health and the risk of osteoporosis and fracture in later adulthood. A myriad of disorders, medications and treatments have been associated with decreased bone mineral density in childhood. In addition, lifestyle factors including poor dietary habits and minimal physical activity have been associated with low bone mass. Despite this, there has been a lack of consensus about how to effectively identify and treat children with decreased bone density. Initial treatment has been directed at treating secondary causes of osteoporosis and addressing modifiable risk factors. Pharmaceutical agents have been utilized in patients who fail to increase bone mass despite addressing secondary causes and modifiable risk factors. The purpose of this paper was to review the diagnostic criteria, etiologies, prevention and treatment strategies of osteoporosis in children and adolescents