How to find out if your child has osteoporosis?

If your child has a broken bone after only a minor bump or has unexplained persistent back pain, it is important that you contact us, to discuss the potential risk of osteoporosis.

  • A risk assessment for osteoporosis should be filled out.
  • Your child may need to be referred to an Osteoporosis specialist, Paediatric rheumatologist, Paediatric orthopaedic surgeon, or Paediatric endocrinologist.
  • DXA scan of the spine to determine the condition of their bones.
  • To exclude any underlying causes for the broken bones, blood tests may be ordered.
  • An X-ray of their non-dominant hand and additional X-Rays may be taken to rule out fractures.
  • An MRI scan, isotope bone scan, a skin biopsy, or a bone biopsy may be done to help make a diagnosis.

This depends on what the causes of bone loss are and what can be done to reduce the risk of fractures, and the child’s quality of life. Usually, lifestyle changes are the main treatment for children. These include the following:


It is essential that every child gets the recommend daily amount of Calcium, Vitamin D, and protein for healthy bones. Please see nutrition section.

If your child is lactose intolerant or does not like dairy products, supplements may be necessary, if the child cannot get the daily requirements from food.

Vitamin D is essential for calcium absorption and Vitamin D drops are available for babies and young children.


Manipulations are not usually recommended for those with osteoporosis.
Weight-bearing and strengthening exercise is essential but should be done on an individualised basis, and should be based on DXA scan results, medical history, cause/s of osteoporosis, and the ability of the child, under the assessment and guidance of a health professional such as a Chartered Physiotherapist.

Walking, running, jogging, tennis, football, skipping, hopping, and best of all dancing are all examples of weight-bearing exercises. Dancing is excellent for building up bone strength.

Contact sports such as rugby and hurling are usually not recommended due to the increased risk of fracture. Skateboarding, ice-skating, and skiing would not be recommended. We would not recommend children be encouraged to participate in ballet or gymnastics due to the increased risk of eating disorders and excessive strains on joints. It is important that children be encouraged to lead as normal a life as possible, and team sports help communication skills and teamwork.

Swimming is good exercise, as it helps to strengthen muscles and build up endurance however, it is not weight-bearing and therefore should not be the only form of exercise.


Alendronate, Clodronate, Etidronate and Pamidronate are all types of bisphosphonates. Research shows these drugs help to reduce the activity of osteoclasts, which are the bone-clearing cells in adults. There is some concern about prescribing them for children, as they stay in the skeleton for an unknown amount of time, and we do not know what their long-term effect may be. However, in some children with osteoporosis, they may be the best treatment option for quality of life, compared to their risk of multiple fractures and the secondary effects of fractures.

Growth Hormone

If your child has a growth hormone deficiency, replacement therapy may be advised by the specialist.

Sex Hormones

After a thorough and detailed investigation, in select cases of delayed puberty, testosterone or oestrogen may be used to treat boys and girls. This type of treatment must be monitored closely because it brings on puberty. It can cause unwanted side effects, for example, it may result in reduced adult height.

Monitoring response to treatment

Usually, a yearly check-up is required to monitor the child’s response to their treatment plan. A DXA scan is usually recommended, to help the specialist evaluate the child’s response to the treatment plan, so adjustments can be made, as necessary.