Idiopathic juvenile osteoporosis is the occurrence of bone loss in children and adolescents. The cause of the disease is unknown.
What is idiopathic juvenile osteoporosis?
According to abbreviationfinder, idiopathic juvenile osteoporosis usually becomes noticeable in prepuberty, i.e. between the ages of 8 and 12, with pain in the lower back region, hips and feet.
Idiopathic juvenile osteoporosis (IJO) is a form of bone loss that appears in childhood and adolescence. It is also called Dent-Friedman syndrome because it is named after physicians Dent and Friedman, who first described it in 1965. Another name for the bone disease is osteoporosis in childhood and adolescence.
Osteoporosis is a progressive disease characterized by loss of bone density. It’s also possible that there is a lack of bone formation, which weakens the bones, making them significantly more prone to breakage. Even minor falls that would not normally result in serious damage can fracture the affected bone.
As a rule, older people are particularly affected by osteoporosis. In rare cases, bone loss can also be seen in children or adolescents. Doctors then speak of juvenile or idiopathic juvenile osteoporosis. On average, children between the ages of 8 and 14 develop this form of osteoporosis. In younger children, bone loss also sometimes occurs during growth spurts.
Causes
In many cases, no specific cause for the development of bone loss can be found in juvenile osteoporosis. For this reason the term idiopathic juvenile osteoporosis is used. In some cases, the bone loss is also the result of a genetic disorder, which includes, for example, osteogenesis imperfecta, or an underlying disease that triggers it.
Then it is secondary juvenile osteoporosis. The diseases that can trigger secondary osteoporosis in childhood and adolescence include juvenile arthritis, hyperthyroidism, hyperparathyroidism, diabetes mellitus, Cushing’s syndrome, kidney diseases, anorexia nervosa, homocystinuria and malabsorption syndromes.
Sometimes the intake of certain drugs also promotes the development of juvenile osteoporosis. These include primarily corticosteroids, antiseizure drugs, and immunosuppressants. It is not uncommon for the lifestyle of the affected children to play a role in the onset of bone loss. They are often unusually inactive or deficient in vitamin D and calcium.
Symptoms, Ailments & Signs
Idiopathic juvenile osteoporosis usually becomes noticeable in prepuberty, i.e. between the ages of 8 and 12, with pain in the lower back region, hips and feet. Affected children often have problems walking. The joints and lower spine are also affected. In addition, growth often comes to a standstill, so that the height of the child decreases.
As the disease progresses, the general bone loss increases and so-called fish vertebrae form. Fractures of the vertebrae and compression fractures of the long tubular bones are not uncommon. Other features include a shortened chest and an abnormal curvature of the upper spine, also known as kyphosis.
Diagnosis & course of disease
In order to be able to take timely therapeutic measures against idiopathic juvenile osteoporosis, an early diagnosis is extremely important. In this way, the bones can be better protected against fractures. The typical symptoms are an important indication of the presence of idiopathic juvenile osteoporosis. In addition, the doctor will take x-rays of the skeleton and measure bone density.
The typical changes in the spine can usually be recognized quickly on the X-ray images. Bone density measurement is used to determine the demineralization of the bones. From a histological point of view, loosening of the cortical bone, a rarefaction of the trabecula and a reduced amount of osteoid can be determined.
Differential diagnosis also plays an important role. It is important to differentiate juvenile polyarthritis, juvenile idiopathic arthritis, rickets, osteogenesis imperfecta or eating disorders from the IJO. The course of idiopathic juvenile osteoporosis is usually positive. After the onset of puberty, there is usually a spontaneous improvement. In severe cases, however, there is a risk of permanent disability due to deformities in the ribs or a curvature of the spine.
Complications
This disease causes bone loss. This usually has a very negative effect on the patient’s everyday life and quality of life. Juvenile osteoporosis causes severe pain in the feet and hips. However, this pain does not appear before the age of eight, which is why an early diagnosis of this disease is not possible.
Furthermore, there are difficulties in walking and possibly restricted movement of the patient. The spine and various joints can also be affected by the disease. It is not uncommon for growth to come to a standstill, resulting in short stature. The risk of fractures is also increased by juvenile osteoporosis.
In most cases, the pain leads to limitations in everyday life and often to depressive moods. The patient’s resilience drops enormously and the affected person appears tired and exhausted. In some cases, the disease can resolve spontaneously, requiring no specific treatment. In general, treatment can only be achieved with the help of medication or physical therapy, although a cure cannot be guaranteed. Life expectancy is not limited by the disease.
When should you go to the doctor?
If adolescents repeatedly complain about aching bones, increased attention is required. If the symptoms persist for several days or if they increase in intensity, a doctor is needed. Initially, the signs can be mistaken for growth symptoms. A doctor’s visit is necessary if the pain spreads throughout the body or the child shows particularly abnormal behavior. Back, hip, or foot discomfort must be evaluated and treated as soon as it persists.
If falls or accidents can be ruled out as the cause, medical examinations must be initiated. If mobility is restricted, if the joints can no longer be used as usual, or if the child’s physical performance decreases, a doctor’s visit must be made. A doctor should be consulted in the event of sleep disorders, headaches, attention and concentration deficits or general malaise.
If optical changes occur in the skeletal system, a doctor must be informed immediately of the observations. There is a risk of further damage, which must be prevented in good time. In the case of mental problems, emotional abnormalities and a refusal attitude of the child, a doctor is needed. If growth stops very early, between the ages of 8 and 12, it is advisable to have this development clarified by a doctor.
Treatment & Therapy
So far, no uniform form of treatment for idiopathic juvenile osteoporosis has been developed. The therapy is determined by the doctor based on certain factors. This includes the extent of bone loss, the child’s age, general health, medical history, and how the child is responding to certain treatments and medicines. In some cases, no therapy is necessary at all because the osteoporosis develops again.
If treatment has to be carried out, the protection of bones and vertebrae from fractures is paramount. The most important therapeutic measures include physical training, physiotherapy and other measures that have a supportive effect. The additional administration of vitamin D, calcium, calcitonin and fluoride is also considered promising.
In persistent cases, bisphosphonates are also given. These funds usually have a positive effect. A balanced, healthy diet for the child is also important. If there is an underlying disease that triggers secondary juvenile osteoporosis, it must be treated accordingly.
Outlook & Forecast
Idiopathic juvenile osteoporosis is a particularly insidious form of osteoporosis because it is often not suspected due to the patient’s age. This means the patient may have lived with her for quite some time without her being diagnosed and treated. Since no cause is known for the early onset of osteoporosis, its course can no longer be stopped, so symptoms and damage will occur. However, modern medicine can slow down the course once osteoporosis has been recognized as such. As a result, the relatively young patient remains physically fit for a long time and, with a bit of luck, even almost symptom-free.
At worst, however, osteoporosis causes lasting damage at an age when most people are still a long way from developing such degenerative diseases. The earlier such damage to the bones occurs, the more time it has later in life to worsen. This can also affect the way of life, because a young person has to be more careful not to put too much strain on the bones, otherwise they could break. Sport and exercise are made significantly more difficult in this way. However, the less a person is able to move, the more inclined they are towards a generally unhealthy lifestyle, which in turn can bring about new problems.
Prevention
Because the causes of idiopathic juvenile osteoporosis are unknown, preventing bone loss is difficult. In general, it is recommended that the child maintain their body weight and move around a lot. In addition, it should always be supplied with sufficient calcium.
Aftercare
Idiopathic juvenile osteoporosis requires comprehensive preventive and follow-up care. The early onset of damage to the skeleton increases the risk of the disease getting worse. This risk can be reduced with a healthy lifestyle. It is important to find the right amount of movement so as not to strain the bones too much.
Those affected are therefore more likely to choose the gentle types of sport. You shouldn’t do without exercise, otherwise other problems such as obesity can follow. In order to counteract the bone loss, patients should ensure sufficient exercise and a reasonable body weight even as children. A diet with sufficient nutrients and calcium provides the body with good support.
Dairy products in particular contain a lot of calcium. Vitamin D improves the body’s absorption of calcium. Nuts, seeds and green vegetables are also recommended. Sporting activities should have as little risk of injury as possible. Among other things, gentle gymnastics, swimming or dancing are offered.
However, team sports increase the risk of breaking bones, so soccer or basketball is not recommended. With physiotherapy, the skeleton can be further stabilized as a supporting apparatus. The young patients should be careful in everyday life and not lift heavy loads.
You can do that yourself
Children and adolescents with juvenile idiopathic osteoporosis should exercise to strengthen bones and muscles. All sports that promote strength and endurance and are associated with a low risk of injury, such as jogging, swimming or dancing, are suitable. Contact and team sports carry the risk of breaking a bone and are therefore less recommended. Targeted gymnastic exercises under the guidance of a physiotherapist additionally stabilize the supporting system of the body. Sick children and young people should not lift or carry anything heavy to avoid permanent damage to the spine.
A balanced diet with a high proportion of calcium-rich foods is important: Dairy products are very good sources of calcium, but green vegetables such as kale, fennel and broccoli as well as seeds and nuts also contain a lot of calcium. Vitamin D is necessary for the body to absorb enough calcium. The organism can form this itself under the influence of sunlight: Affected children and adolescents should therefore be exposed to sunlight for at least half an hour every day to promote the production of vitamin D. oxalic acid and phosphatesinhibit the absorption of calcium: The consumption of spinach, rhubarb, beetroot, meat, sausage products, cocoa and Coca Cola is therefore only recommended in small amounts.
