What are the symptoms? Symptoms will vary from child to child, but may include: pain in the bone often in the back, hips, legs and feetdifficulty in walkingfractures (broken bones) in the long bones of the skeleton and in the spinecurvature of the spine (scoliosis), or a height loss where the bones in the spine have become squashed or misshapen. What are the causes? Primary juvenile osteoporosis is described as bone density loss in a previously healthy child/teenager with a history of bone breaks (arms, legs or spine) for no apparent reason. It is ‘idopathic’ because there is no known cause. Secondary juvenile osteoporosis occurs due to other reasons such as another illness or a medication. Including: inflammatory conditions (such as juvenile arthritis (see entry Arthritis (Juvenile Idiopathic)) or Crohn’s disease (see entry Crohn’s and Ulcerative Colitis))anorexia nervosa (see entry Eating disorders)long-term, high-dose oral corticosteroid treatmentosteogenesis imperfecta (OI) (see entry Brittle Bone disease) – a genetic disorder that affects the collagen, which is an important part of boneconditions causing immobility for example spinal cord injury and cerebral palsy. How is it diagnosed? Juvenile osteoporosis may be discovered when other problems are investigated, such as fractures or difficulty walking. Children will probably be referred to a specialist for further assessment, which can include: X-rays to examine the skeleton for fracturesdual energy x-ray absorptiometry (DXA) – bone density scans to assess the degree of bone density loss. Sometimes other types of scan are used, such as quantitative computerised tomography (QCT or CT)bone biopsies, removal of a small amount of bone tissue, to look at the internal structure of the bone. How is it treated? Parents of children with osteoporosis will be advised to ensure the child has a well-balanced, calcium-rich diet and do plenty of weight-bearing exercise. Physiotherapy may be advised in some children to aid mobility. Some children may need medication that is used in adults with osteoporosis but at smaller doses. Examples include bisphosphonate (drugs that affect the bone cells and the ongoing process of bone renewal) or forms of vitamin D to influence the body’s absorption of calcium. Monitoring will be needed to check the child’s bone density and how the condition is progressing in light of treatment. Inheritance patterns and prenatal diagnosis Inheritance patternsJuvenile osteoporosis has been recognised as more likely to occur in some families, but a genetic cause has not been fully established. Prenatal diagnosisNot applicable. Is there support? Royal Osteoporosis Society Helpline: 0808 800 0035Email: firstname.lastname@example.orgWebsite: theros.org.uk The Society is a Registered Charity in England and Wales No. 11022712. It offers information and support to anyone affected by osteoporosis, including providing information about osteoporosis in children. The Society has a network of support groups across the UK. Group details last updated June 2021.