Diagnosis of Osteoporosis in Children

Since the endorsed use of pediatric bone software to assess bone mass through DXA in the 1990s, some concepts have been established to arrive at a correct interpretation of bone mineral density in this population. This review describes all elements that should be considered when diagnosing bone mineral density diminished for age. The use of the Z-score instead of the T-score and the history of bone fractures (only fractures of long bones and vertebral crushing are considered clinically relevant) are discussed. The evaluation of BMD (Bone Mineral Density) values by DXA according to pubertal stage, sex, and bone age is clarified. In addition mention is made of diseases which must be ruled out by clinical and biochemical parameters; the latter vary according to age and sex, so that the normal reference value for adults should not be used.