There is no generally accepted definition of osteoporosis in children. To find out if an adult has low bone density or osteoporosis, a bone density test is done. However, bone density testing in children is not usually recommended in children. Bone density testing in children may be recommended in certain rare cases, such as when a child has broken multiple bones or when a child breaks bones that are unusual for children, such as breaks in the hip and spine. A healthcare provider may also suggest a bone density test in children with unusual medical problems that are associated with low bone density.

Low bone density is defined differently in children than it is in adults. Bone density is considered to be low in children who have a Z-score of -2.0 or below on a bone density test.

Low bone density in children is often due to genetics but may also be due to other medical conditions or medicines used to treat certain diseases. Sometimes, however, there is no known cause for low bone density in children.

Below are several known causes of either low bone density or unusual broken bones in children:

Osteogenesis imperfecta. In some cases, children who break bones easily have an underlying problem with their bones called osteogenesis imperfecta. This condition is different from osteoporosis. It is a genetic disorder that causes weak bones. It can be diagnosed with special testing. A resource for more information is the Osteogenesis Imperfecta Foundation.

Idiopathic juvenile osteoporosis. Idiopathic juvenile osteoporosis is a rare form of osteoporosis in children. It affects children between the ages of 1 and 13. Its cause is unknown. Children with this condition tend to have broken bones, particularly in the legs and spine. Treatment includes calcium and vitamin D, and in some cases medicine. Fortunately, this type of osteoporosis usually goes away when a child becomes a teenager. Experts are not sure if this condition will affect bone health later in life.

Low bone density caused by steroid medicines. Steroid medicines taken in high doses over a long period of time can slow bone growth in children. This increases their chance of having low bone density. Steroids are medicines used to treat diseases such as arthritis, asthma and Crohn’s disease. If your child needs to take a steroid medicine, speak with your child’s healthcare provider about the steps to take to protect his or her bones.

Treatment of children. The Food and Drug Administration (FDA) has not approved the use of osteoporosis medicines in children. If your child has had multiple broken bones, it’s important that he or she is under the care of a pediatric doctor with specialized knowledge about bone health.

It remains important for all children to consume a well-balanced diet that is rich in calcium and vitamin D. Children can also build strong bones by getting plenty of exercise.

Additional Related Topics

Having a Bone Density Test - more information about T-scores.

Medicines That May Cause Bone Loss - more information about steroid medicines and their relation to bone loss

Vitamin D and Bone Health - vitamin D recommendations for children. 

Calcium and Bone Health - calcium recommendations for children.