Chapter 698 Osteoporosis
Osteoporosis is relatively uncommon in children even though it is the most common bone disorder in adults. Bone volume is diminished and the incidence of fractures is greatly increased in this condition. In contrast to osteomalacia, which shows undermineralization and normal bone volume, histologic sections of bone in all forms of osteoporosis reveal a normal degree of mineralization but a reduction in the volume of bone, especially trabecular bone (vertebral bone). In osteoporosis, by definition, there is also a reduced amount of bone tissue (termed osteopenia), which is associated with atraumatic (pathologic) fractures. Osteoporosis in children may be primary or secondary (Table 698-1). The primary osteoporoses can be divided into heritable disorders of connective tissue, including osteogenesis imperfecta, Bruck syndrome, osteoporosis-pseudoglioma syndrome, Ehlers-Danlos syndrome, Marfan syndrome, homocystinuria, and idiopathic juvenile osteoporosis. Secondary forms of osteoporosis include various neuromuscular disorders, chronic illness, endocrine disorders, and drug-induced and inborn errors of metabolism, including lysinuric protein intolerance and Gaucher disease.
Table 698-1 RISKS FOR OSTEOPOROSIS
ENDOCRINE DISORDERS
Female Hypogonadism
Male Hypogonadism
INFLAMMATORY DISORDERS
GASTROINTESTINAL DISORDERS
BONE MARROW DISORDERS
CONNECTIVE TISSUE/BONE DISORDERS
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