What are the ISCD recommendations for diagnosing osteoporosis in children and adolescents?

Updated: Jan 20, 2021
  • Author: Rachel Elizabeth Whitaker Elam, MD, MSc; Chief Editor: Herbert S Diamond, MD  more...
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The official position of the International Society for Clinical Densitometry (ISCD) is that “fracture prediction should primarily identify children at risk of clinically significant fractures” (eg, fracture of lower-extremity long bones, vertebral compression fractures, or two or more upper-extremity long-bone fractures). [5] However, densitometric criteria alone should not be used to diagnose osteoporosis in children and adolescents. Rather, such a diagnosis in this population must be based on a low bone mineral content (BMC) or BMD in conjunction with a clinically significant fracture history. Fractures are considered clinically significant [5] if one or more of the following are present:

  • Lower-extremity long-bone fracture
  • Vertebral compression fracture
  • Two or more upper-extremity long-bone fractures
  • Low BMC or BMD, defined as a BMC or areal BMD Z-score that is –2.0 or less, adjusted for age, sex, and body size, as appropriate

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