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Osteoporosis in children and young adults
Institution:1. Department of Endocrinology and Diabetes, Evelina London Children’s Hospital, London, UK;2. GKT School of Medical Education, King’s College London, UK;3. Department of Endocrinology, Metabolism and Diabetes, First Department of Paediatrics, Athens University Medical School, ‘Aghia Sophia Children’s Hospital’, Athens, Greece
Abstract:Osteoporosis is a major public health problem with serious long-term complications. In children, the definition of osteoporosis is not only based on densitometric criteria but also takes into account vertebral and long bone fragility fractures. Several factors, such as long-term high-dose steroids, chronic inflammation, malnutrition, immobility, lack of sex steroids, and medication can reduce bone density and increase the risk for fragility fractures when left untreated. Also, genetic conditions can predispose to primary bone fragility disorders, with osteogenesis imperfecta being the most common. Furthermore, since the growing skeleton is at an increased rate of bone remodeling, the ability to heal long bone fractures and reshape vertebral fractures differentiates children from adults. The scope of this chapter is to review the risk factors of osteoporosis and fragility fractures and describe the commonest causes of primary and secondary osteoporosis and their management in children and young adults.
Keywords:Osteoporosis  Fragility fractures  Children  Young adults  Glucocorticoids  Bisphosphonates  VFs"}  {"#name":"keyword"  "$":{"id":"pc_dat45ANJe7"}  "$$":[{"#name":"text"  "_":"vertebral fractures  MRI"}  {"#name":"keyword"  "$":{"id":"pc_gql5hGz5s5"}  "$$":[{"#name":"text"  "_":"magnetic resonance imaging  CT"}  {"#name":"keyword"  "$":{"id":"pc_oLC1mwxT9h"}  "$$":[{"#name":"text"  "_":"computed tomography  BMD"}  {"#name":"keyword"  "$":{"id":"pc_hkCON4Bkb5"}  "$$":[{"#name":"text"  "_":"bone mineral density  VFA"}  {"#name":"keyword"  "$":{"id":"pc_fH94wONjJK"}  "$$":[{"#name":"text"  "_":"vertebral fracture assessment  DXA"}  {"#name":"keyword"  "$":{"id":"pc_6d1ZT9NCSj"}  "$$":[{"#name":"text"  "_":"Dual energy X-ray absorptiometry  LS"}  {"#name":"keyword"  "$":{"id":"pc_WCtwIOthz0"}  "$$":[{"#name":"text"  "_":"lumbar spine  WBLH"}  {"#name":"keyword"  "$":{"id":"pc_uHw0elIoqD"}  "$$":[{"#name":"text"  "_":"whole body less head  BMAD"}  {"#name":"keyword"  "$":{"id":"pc_hOtExsyvUh"}  "$$":[{"#name":"text"  "_":"Bone Mineral Apparent Density  HAZ"}  {"#name":"keyword"  "$":{"id":"pc_8Agx4JS6A7"}  "$$":[{"#name":"text"  "_":"height adjusted z-score  QCT"}  {"#name":"keyword"  "$":{"id":"pc_1vnYC9h2LH"}  "$$":[{"#name":"text"  "_":"quantitative computed tomography  pQCT"}  {"#name":"keyword"  "$":{"id":"pc_8stGfcrwo2"}  "$$":[{"#name":"text"  "_":"peripheralquantitative computed tomography  DMD"}  {"#name":"keyword"  "$":{"id":"pc_qwwOR9dVvo"}  "$$":[{"#name":"text"  "_":"Duchenne muscular dystrophy  IBD"}  {"#name":"keyword"  "$":{"id":"pc_0TTVqKzq3p"}  "$$":[{"#name":"text"  "_":"inflammatory bowel disease  GH"}  {"#name":"keyword"  "$":{"id":"pc_qEuUO9alge"}  "$$":[{"#name":"text"  "_":"growth hormone  RANKL"}  {"#name":"keyword"  "$":{"id":"pc_eJXkUeWvVq"}  "$$":[{"#name":"text"  "_":"receptor activator of nuclear factor κΒ ligand  OPG"}  {"#name":"keyword"  "$":{"id":"pc_qEAiQXLSd9"}  "$$":[{"#name":"text"  "_":"osteoprotegerin  OI"}  {"#name":"keyword"  "$":{"id":"pc_AQzNHpf3ow"}  "$$":[{"#name":"text"  "_":"osteogenesis imperfecta  ALL"}  {"#name":"keyword"  "$":{"id":"pc_Q36rMQPmlI"}  "$$":[{"#name":"text"  "_":"acute lymphoblastic leukemia  JIA"}  {"#name":"keyword"  "$":{"id":"pc_JJ5nDSuVyr"}  "$$":[{"#name":"text"  "_":"juvenile idiopathic arthritis  CD"}  {"#name":"keyword"  "$":{"id":"pc_qOfEosckLz"}  "$$":[{"#name":"text"  "_":"Crohn's Disease  TM"}  {"#name":"keyword"  "$":{"id":"pc_MFRhAhZD1U"}  "$$":[{"#name":"text"  "_":"thalassemia major  SCD"}  {"#name":"keyword"  "$":{"id":"pc_xithSW35tH"}  "$$":[{"#name":"text"  "_":"sickle cell disease  ZA"}  {"#name":"keyword"  "$":{"id":"pc_Qwj6Gs9d1E"}  "$$":[{"#name":"text"  "_":"zoledronic acid
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