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Childhood Bone Disorders

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Children often have a lot of energy, and it can get them into trouble sometimes. It is not uncommon for them to fall in the midst of an activity and break a bone. What isless common is an actual bone disorder. There are a few somewhat common childhood bone disorders: vitamin D deficiency, rickets, recurrent fractures, osteogenesis imperfecta (brittle bones), and osteoporosis, just to name a few. Though they may have similar symptoms, each disorder is slightly different and requires its own specific diagnosis and treatment. The following is an overview of some well-known bone disorders that can affect children.

Vitamin D Deficiency

Vitamin D is an essential nutrient found in some natural foods like fish and egg yolks, but it is also made by skin that's exposed to sunlight. Vitamin D is important because it works with calcium to form and maintain bone. Without vitamin D, calcium would not be absorbed and bones would weaken, and that is exactly what happens with vitamin D deficiency.

Vitamin D deficiency results in subtle symptoms of bone pain or muscle weakness. The deficiency can be caused by a strict vegan diet, not getting enough sunlight, dark skin, obesity, or certain medical problems that affect the digestive tract's ability to absorb vitamin D from food. The disorder is simply treated by increasing vitamin D in the body through diet, supplements, and exposure to sunlight.


Rickets is a rare disorder most commonly seen in children ages 6-24 months. It results in the softening of bones due to a lack of calcium, vitamin D, phosphate, or a combination of the three. However, vitamin D deficiency is the most common cause. Exclusively breastfed infants are especially prone to rickets since breastmilk is not a good source of vitamin D. There are other causes of rickets that are not related to vitamin D deficiency. Hereditary rickets is different in that it affects phosphate levels the kidneys cannot maintain the mineral. Other kidney disorders can also cause rickets.

Symptoms of rickets include loss of muscle tone, delayed tooth development or dental deformities, bone pain, muscle cramps, and skeletal deformities such as bowlegs and scoliosis. The treatment corrects the cause. Replenishing the nutrient that was lacking and causing the disorder should eliminate most symptoms. However, in the case of skeletal deformities, braces or surgery may be needed to correct the symptoms. Luckily, if the child is young, the outlook is very good. As long as the rickets is corrected while the child is still growing, any skeletal, deformities will likely not be permanent and may improve with time.

Recurrent Fractures

Recurrent fractures may be the result of other bone disorders, and they are especially problematic in children. One study found that children who sustain multiple fractures have lower bone mass than children who have not experienced fractures. Unfortunately, recurrent fractures are often a result of child abuse, but in a fair amount of cases, other bone disorders are the cause. Children with recurrent fractures should be tested for disorders that could contribute to the fractures, such as rickets, osteomyelitis, copper deficiency, and osteogenesis imperfecta. If one of these disorders is found to be the cause, it is a simple matter of treating that specific condition, and hopefully, then the fractures will become less frequent. It is important to recognize recurrent fractures and their causes early in childhood before the fractures result in permanent damage and bone loss.

Osteogenesis Imperfecta

This bone disorder literally translates to "imperfect formation of the bone". It is more commonly known as "brittle bone disease", which is a rare genetic disorder that presents at birth and is characterized by fragile bones. There are six different types within the broader classification of osteogenesis imperfecta. Type I is the mildest form and luckily the most common. Usually, there is no bone deformity and the disorder is not obvious. Types IV-VI are all moderate forms. Type III includes those born with fractures that could experience as many as a couple hundred fractures in their lifetime. Type II is the most severe form and often results in death shortly after birth due to respiratory problems.

Since genes essentially cause osteogenesis imperfecta, it can be somewhat difficult to diagnose. However, frequent fractures with seemingly no cause other than a minor accident are the telltale signs. Family histories and genetic testing can help with diagnosis, and further urine and blood tests can be done to rule out potential other causes. Osteogenesis imperfecta is impossible to cure, but people can learn to live with it. They learn how to care for fractures and how to partake in safe exercise, like swimming. They often go through physical therapy in order to strengthen muscles and improve motor skills. Treatment may also focus on a nutritious diet and a generally healthy lifestyle.


Osteoporosis is not just an adult's disease; there is such a thing as juvenile osteoporosis. It is most common for children ages 8-14 but can hit younger children going through growth spurts, as well. There are two types of juvenile osteoporosis: secondary and idiopathic. Secondary osteoporosis can be caused by a variety of other medical conditions, such as diabetes, celiac disease, kidney disease, leukemia, and cystic fibrosis. Idiopathic osteoporosis is far rarer and there is no known cause.

In general, osteoporosis is a decrease in bone mass. Some common symptoms of juvenile osteoporosis are difficulty-walking, fractures that are caused too easily, and pain in the lower body, such as in the feet or knees. The best way to treat secondary osteoporosis is to treat the underlying condition causing the bone disorder. Idiopathic osteoporosis has no known treatment, so the best things to do are provide enough calcium and vitamin D in the diet and try to prevent fractures.

Vitamin D deficiency, rickets, recurrent fractures, osteogenesis imperfecta (brittle bones), and osteoporosis are just a few of the bone disorders that can affect children. It is clear that they all have different causes, symptoms, and treatment, so it is important that if a bone disorder is suspected, the child be taken to a doctor to determine exactly what's wrong so the right treatment can be prescribed.