Paediatric osteoporosis – ISCD criteria — RACP Paediatrics MCQ

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HardEndocrinePaediatric osteoporosis – ISCD criteriaRACP Paediatrics

The same child sustains 2 long bone fractures from minimal trauma over the next year. DXA now shows Z-score -2.3. What is the correct diagnosis per ISCD criteria?

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Correct answer: E — Osteoporosis with fracture – treat

Osteoporosis in children per ISCD requires: BMD Z-score ≤-2.0 PLUS clinically significant fracture history (≥2 long bone fractures by age 10, or ≥3 by age 19, or vertebral compression fractures). This child now meets both criteria. Bisphosphonate therapy (IV pamidronate or zoledronate) should be considered alongside addressing the underlying cause.

Reference: ISCD – 2019 – Paediatric Official Positions; RACP Paediatric Curriculum – Endocrine