Causes, diagnosis, and treatment of pediatric osteoporosis

Article information

J Korean Med Assoc. 2018;61(10):616-622
Publication date (electronic) : 2018 October 22
doi :
Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
Corresponding author: Jung Sub Lim.
Received 2018 August 23; Accepted 2018 September 04.


Osteoporosis was once thought to be a disease of the elderly. Now, there is universal agreement that osteoporosis has a pediatric origin. If individuals fail to achieve optimal peak bone mass and strength in childhood and adolescence, the development of osteoporosis later in life becomes more likely. Furthermore, increased knowledge and improved care for children with genetic disease and chronic illnesses has led to many children living long enough to develop osteoporosis and fractures even in childhood or adolescence. Thus, early interventions including nutrition, exercise, and pharmacological treatment are paramount. The objective of this review is to help clinicians diagnose and manage children at a high risk of osteoporosis. This article also reviews the latest advances in the treatment of pediatric osteoporosis including Korean experiences.


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Figure 1

Algorithm to prevent osteoporosis in childhood cancer survivors. LTFU, long-term follow-up; GHD, growth hormone deficiency; DXA, dual energy X-ray absorptiometry; BMD, bone mineral density. Reproduced from Kang MJ, et al. Korean J Pediatr 2013;56:60-67, according to the Creative Commons license [20].

Table 1

List of diseases associated with low bone mass or fractures in children and adolescents

Table 1