Juvenile Osteoporosis

When teenagers complain of pain in the back, legs, knees and feet, listen closely. It may not be 'just growing pains.' If your child has a chronic condition, juvenile osteoporosis can occur as a secondary disease. Another type of juvenile osteoporosis, though rare, can strike seemingly 'healthy' kids.

Must less frequently than 'secondary osteoporosis' (caused from another prevailing chronic disease) is a form of osteoporosis caused by a lack of calcium in the diet. This form is IJO (Idiopathic Juvenile Osteoporosis). Sometimes, the symptoms are not recognized as serious.

A growing teen can and does complain of generalized aches and pain in the legs, arms, back etc. while in a growth spurt or after playing strenuous sports. This is common, but in a child whose diet has been lacking in calcium and healthy foods, it could signal symptoms of something more serious. Bone loss can occur from years of 'junk foods', unhealthy diets and unhealthy living styles.

There are three different forms of juvenile osteoporosis. The most common form is called "Secondary" osteoporosis and is associated with another underlying condition. (see below)

Occasionally, juvenile osteoporosis is genetic, as with the condition osteogenesis imperfecta, commonly called 'brittle bone disease'.

The third type is IJO and is caused from a diet lacking in calcium.

The word, OSTEOPOROSIS means 'porous bone' which means there is too little bone formation in the bone making it very fragile and prone to fracturing. In children, this is generally caused by a primary underlying disease. Juvenile osteoporosis can be a serious problem because it occurs during the bone-building years. From birth to early adulthood children accumulate bone mass, but after 30, we normally slowly start losing bone density. If bones are not at their peak density before about age 30, as older adults, serious osteoporosis complications can occur.

In children, a number of other disorders may be the cause of osteoporosis. These can include juvenile arthritis, kidney disease, diabetes mellitus, anorexia nervosa, osteogenesis imperfecta (brittle bone disease), Cushing's syndrome, other malabsorption disorders and various thyroid and parathyroid disorders.

Others things can also cause juvenile osteoporosis. These include Medications (used to treat some of the above conditions) and Lifestyle. If a child is very inactive and immobile, his or her bones can lose calcium leading to osteoporosis. In females, excessive exercising leading to amenorrhea (the absence of menstruation) can contribute to Juvenile osteoporosis. Inactivity in children with rheumatoid arthritis is one of the most common causes of osteoporosis. They live a sedentary life because of the pain associated with their arthritis. They don't get much weight-bearing exercise which leads to the depletion of calcium in the skeleton. Adequate calcium in the diet and the level of physical activity influences the development of peak bone mass and also the rate that bone is lost later in life.

Helping to prevent the possibility of childhood osteoporosis in your child is important. Make sure that your child remains healthy by doing the following:

Seeing that your child maintains a normal body weight

Seeing that your child exercises regularly (Weight-bearing exercise)

Minimize the child's caffeine intake

See that your child has an adequate intake of calcium.

(This may include calcium supplements and vitamin D for absorption)

The minimum daily requirements for calcium are: Children (4-8 years), 800 mg, Teenagers (9-18 years), 1300 mg.

Idiopathic Juvenile Osteoporosis is a rare type of osteoporosis in children IJO usually occurs just at the start of puberty. The first sign of IJO is pain in the back, hips, feet, knees and ankles and fractures of the legs and feet. Physical symptoms include loss of height, curvatures of the spine, chest malformations (sunken chest) and limping.

Diagnosis of idiopathic juvenile osteoporosis can be made only when other, underlying conditions have been ruled out. Sometimes these symptoms are reversible if caught early. Most children can catch up to their normal height with good diet, exercise and calcium/vitamin D replacement.

Low bone density and collapsed and misaligned and misshapen vertebrae can be detected by standard x-ray, but by the time they are seen on x-ray, sufficient bone loss has happened. Detection by newer methods such as a CAT scan can diagnosis bone loss earlier and more accurately than standard x-rays.

The treatment of secondary juvenile osteoporosis is to identify and treat the underlying disease, but in idiopathic juvenile osteoporosis, the IJO is the primary condition and there is usually no treatment needed because the disease, most times, goes away spontaneously.

Early diagnosis is important to identify IJO so the child's spine and bones can be protected until the condition goes into remission. These steps may include physical therapy, avoiding unsafe activities and possibly using crutches. As always, a balanced diet high in calcium and vitamin D is most important.

Sometimes, in severe cases where remission does not happen soon, certain medications are given. These medications are called bisphosphonates. Most children recover completely and replace missing bone tissue. Their growth may be impaired during the acute part of the disease but usually they catch up and normal growth resumes eventually. Infrequently, IJO can result in permanent disability due to ribcage collapse or curvature of the spine.

WHAT PARENTS CAN DO: Watch your child's diet carefully and limit the 'junk food' and caffeine. Make sure he/she is getting adequate daily calcium and vitamin D. If your child complains of severe aching and pain in the legs, back or feet, or you notice any limping or change in skeletal appearance, make an appointment with his/her physician for a complete physical examination.

Sources:

Doreen Bradley Satter, RN

www.webmd.com/osteoporosis/.../juvenile-osteoporosis-types