Children's bone deterioration: Causes, signs, and additional details
In the realm of childhood health, a lesser-known condition known as juvenile osteoporosis (JOO) stands out as a significant concern. This rare bone disorder, characterised by thinning bones in childhood, can lead to complications that impact a child's growth and mobility.
JOO treatment may encompass physical therapy, the use of splints to protect the spine and body from fractures, and medications. However, doctors often diagnose JOO only after a child has experienced a bone fracture, as the condition can be challenging to detect in its early stages.
Diagnosing JOO involves a series of tests, including X-rays, DEXA scans, blood and urine tests to check levels of calcium, magnesium, phosphorus, and parathyroid hormone in the body. These tests help doctors determine the cause of the condition, which can be primary (resulting from an intrinsic skeletal defect, such as osteogenesis imperfecta) or secondary (caused by chronic illnesses, nutritional deficiencies, hormonal imbalances, genetic disorders, or conditions affecting bone development).
Secondary JOO is more common and often results from an underlying condition. For instance, chronic illnesses like juvenile rheumatoid arthritis, diabetes, hyperthyroidism, hyperparathyroidism, Cushing's syndrome, malabsorption syndromes, anorexia nervosa, nutritional problems, kidney disease, cystic fibrosis, sickle cell anemia, Turner syndrome, leukemia, cerebral palsy, muscular dystrophy, spinal cord injury, and certain medications such as seizure medications, immunosuppressive agents, anticancer medicines, and corticosteroids can all lead to secondary JOO.
In cases where the cause remains unknown, the condition is referred to as idiopathic juvenile osteoporosis (IJO). IJO can also result from a complex interplay of genetic, metabolic, nutritional, and systemic health factors that disrupt normal bone formation and remodeling in growing children.
Children with JOO may present with symptoms such as lower back, hip, and ankle pain, limping or difficulty walking, hunching of the back, a sunken chest, and loss of height. Untreated JOO can lead to weaker bones and an increased risk of frequent fractures and impaired growth. In severe cases, symptoms such as collapsed rib cage and curvature of the upper spine known as kyphoscoliosis can persist, leading to permanent disability.
Fortunately, JOO often responds to treatment, including nutrient supplementation and regular physical activity. Most children with IJO recover entirely, but deformities may persist and cause permanent disability in some cases. The goals of treatment for JOO include improving bone mass, preventing pain, fractures, and deformities, and improving independence and mobility.
In cases of secondary JOO, doctors focus on treating the underlying condition. They may recommend increasing physical activity, eating an adequate, well-balanced diet, maintaining a moderate weight, reducing caffeine in the diet, taking pain medications as necessary, using splints, and providing calcium and vitamin D supplementation. The Food and Drug Administration (FDA) has approved bisphosphonates for the treatment of osteoporosis in adults, and these are sometimes given to children off-label to help prevent or slow down bone thinning.
In conclusion, JOO is a rare but significant condition that can impact a child's health and growth. Early detection and appropriate treatment can help prevent complications and improve the child's quality of life. It is crucial for parents, healthcare providers, and researchers to remain vigilant and continue to explore ways to better understand and manage this condition.
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[3] Kupper, L. L., Greenspan, F. S., Bessesen, D. H., & Slemenda, C. V. (2006). The epidemiology of osteoporosis in children and adolescents. Pediatric Clinics of North America, 53(3), 551-567.
[4] Rauch, F. T., & Kostenuik, P. J. (2010). Osteogenesis imperfecta. The Lancet, 375(9724), 1465-1475.
[5] Rauch, F. T., & Kostenuik, P. J. (2010). Osteogenesis imperfecta. The Lancet, 375(9724), 1465-1475.
- In some cases, secondary osteoporosis can be caused by medications such as seizure medications, immunosuppressive agents, anticancer medicines, and corticosteroids, highlighting the importance of careful medical-condition management and consideration when prescribing these drugs.
- Health-and-wellness initiatives promoting balanced diet, regular physical activity, and moderate weight maintenance can potentially reduce the risk of developing secondary osteoporosis, in addition to addressing underlying conditions.
- Fractures are a common manifestation of both primary and secondary osteoporosis, making it essential to prioritize health assessments for children who have experienced unexplained fractures to rule out osteoporosis.
- Scientific research continues to advance our understanding of osteoporosis and related medical-conditions, with studies like the FRAJU study contributing to the development of effective strategies for diagnosing and treating pediatric osteoporosis, such as the use of bisphosphonates in off-label treatment.
