Aetiopathogenesis of osteoporosis is significantly different in children than in adults. Children most commonly present with secondary osteoporosis due to chronic diseases and/or their treatment.
In children, low bone density is diagnosed following DXA findings and fracture history. When considering potential therapy, in addition to bone density parameters and history, the expected development of bone quality or strength should be individually assessed, with respect to the activity of the underlying disease and its therapy.
DXA findings should always be interpreted with respect to anthropometric parameters, in particular the height and stage of puberty, to avoid false overdiagnosis of osteoporosis in children short for their age. Methods based on the assessment of volumetric bone density provide a new perspective on measuring bone strength in children.