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J Am Acad Orthop Surg, Vol 10, No 1, January/February 2002, 57-66.
© 2002 the American Academy of Orthopaedic Surgeons
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Bone Mineral Density Deficiency in Children

P. Justin Tortolani, MD, Edward F. McCarthy, MD and Paul D. Sponseller, MD

Dr. Tortolani is Chief Resident, Department of Orthopaedic Surgery, Johns Hopkins Hospital, Baltimore, Md. Dr. McCarthy is Chief, Division of Bone Pathology, Johns Hopkins Hospital. Dr. Sponseller is Chief, Division of Pediatric Orthopaedic Surgery, Johns Hopkins Hospital.

Reprint requests: Dr. Tortolani, Johns Hopkins Hospital, 601 North Caroline Street, Baltimore, MD 21287-0881.

With the development of improved diagnostic and treatment options, reduced bone mineral density in children is receiving increased attention. The etiology of osteopenia in healthy children is multifactorial and incompletely understood, but poor calcium intake during the adolescent growth spurt may be an important (and potentially reversible) factor. Other clinically relevant causes of reduced bone mineral density in children include osteogenesis imperfecta, rickets, juvenile rheumatoid and other chronic arthritides, osteopenia associated with neuromuscular disorders, and idiopathic osteoporosis. To provide effective treatment, it is important to understand the process of normal skeletal mineralization, the techniques of bone mineral density measurement, the pathophysiology of osteopenia, and the evaluation and treatment options for the general pediatric population as well as for patients with specific pediatric disorders.






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