Iranian Journal of Orthopedic Surgery

Abstract Abstract
Corticosteroids are widely used medications with increasing prevalence in clinical practice. In autoimmune and rheumatological diseases, the use of corticosteroids in both pulsed and long-term manners is very common. Due to the COVID-19 pandemic, their consumption increased. However, long-term use is associated with several adverse effects on the musculoskeletal system, including osteoporosis, an elevated risk of fracture, avascular necrosis, hypocalcemia, hypovitaminosis D, and impaired bone growth in children. Corticosteroid-induced osteoporosis is the most common form of secondary osteoporosis. Several factors, such as age, time of use, family history of osteoporosis, previous fractures, and calcium intake, contribute to its prevalence. Corticosteroids exert their effects by disrupting the balance between the activity of osteoblasts and osteoclasts. These medications also disturb the calcium metabolism by altering intestinal calcium absorption and renal calcium excretion. To minimize these side effects, corticosteroid therapy should be limited whenever possible. Also, supplementing with calcium and vitamin D, incorporating breaks of at least three months between corticosteroid courses, and considering alternative therapies, especially in pediatric patients, can help mitigate the potential risks.

Abstract In recent years, there has been a growing awareness of pediatric osteoporosis, a condition that can lead to weakened bones and a higher risk of fractures in children. It is essential for pediatricians to be knowledgeable about this issue so that they can identify and treat patients with osteoporosis or those at risk for it. Genetic factors and various disorders play a role in bone formation and quality. Osteogenesis imperfecta is the most common genetic condition linked to primary osteoporosis. Secondary osteoporosis can occur in children with chronic illnesses. X-rays can help diagnose the condition. Prevention is key in managing pediatric osteoporosis, as understanding normal bone development allows for early detection and treatment. Medications can help prevent bone loss in pediatric patients. The definition of pediatric osteoporosis involves low bone mass and significant fractures. Factors such as genes, medications, lack of movement, and corticosteroid use can contribute to osteoporosis in children. Treatment options for pediatric osteoporosis are limited, but anabolic agents and bisphosphonates may be used. Close monitoring and follow-up are crucial to prevent further fractures. It is important for pediatricians to understand the diagnosis and treatment of pediatric osteoporosis, as well as lifestyle factors and the effectiveness of treatment approaches.