Evidence mapPaperPMID 42340621Full record

ArticleJournal of endocrinological investigation2026

Practical approach to the diagnosis, management, and treatment of pediatric patients with bone fragility: an expert opinion.

Giampiero I Baroncelli, Daniele Tessaris, Tommaso Aversa, Enrica Bertelli, Pasquale Comberiati, Domenico Corica, Natascia Di Iorgi, Maria Felicia Faienza, Danilo Fintini, Roberto Franceschi and 12 more

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Article in Journal of endocrinological investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

22 authors.

Giampiero I BaroncelliPediatric and Adolescent Endocrinology, Division of Pediatrics, Department of Obstetrics, Gynecology and Pediatrics, University Hospital, Pisa, Italy.ORCID http://orcid.org/0000-0001-8465-5087
Daniele TessarisPediatric Endocrinology, Department of Public Health and Pediatrics, University of Turin, Regina Margherita Children's Hospital, Turin, Italy.ORCID http://orcid.org/0000-0002-6484-4371
Tommaso AversaDepartment of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.ORCID http://orcid.org/0000-0002-1754-6822
Enrica BertelliPediatric and Pediatric Emergency Unit, Children Hospital, Azienda Ospedaliero-Universitaria SS Antonio e Biagio e C. Arrigo, Alessandria, Italy.ORCID http://orcid.org/0000-0002-9597-833X
Pasquale ComberiatiPediatric and Adolescent Endocrinology, Division of Pediatrics, Department of Obstetrics, Gynecology and Pediatrics, University Hospital, Pisa, Italy.ORCID http://orcid.org/0000-0001-5209-9733
Domenico CoricaDepartment of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.ORCID http://orcid.org/0000-0002-3628-1612
Natascia Di IorgiDepartment of Pediatrics, IRCCS Istituto Giannina Gaslini, Genova, Italy.ORCID http://orcid.org/0000-0002-4492-4585
Maria Felicia FaienzaPediatric Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Bari, Italy.ORCID http://orcid.org/0000-0002-1899-8337
Danilo FintiniEndocrinology and Diabetology Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.ORCID http://orcid.org/0000-0002-0103-7951
Roberto FranceschiCentre for Medical Sciences -CISMed, University of Trento, Trento, Italy.ORCID http://orcid.org/0000-0002-2230-7148
Anna GrandoneDepartment of Child Woman, General and Specialized Surgery, University of Campania "L. Vanvitelli", Naples, Italy.ORCID http://orcid.org/0000-0002-6343-4768
Mila Ann KarapurackalDepartment of Pediatrics, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University (PMU), Bolzano, Italy.ORCID http://orcid.org/0009-0004-2186-9853
Silvia LonghiDepartment of Pediatrics, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University (PMU), Bolzano, Italy.ORCID http://orcid.org/0009-0008-3979-2857
Marco PiteaPediatric Endocrinology Unit, Department of Pediatrics, IRCCS Ospedale San Raffaele, Milan, Italy.ORCID http://orcid.org/0009-0004-2753-9230
Andrea SeccoPediatric and Pediatric Emergency Unit, Children Hospital, Azienda Ospedaliero-Universitaria SS Antonio e Biagio e C. Arrigo, Alessandria, Italy.ORCID http://orcid.org/0009-0009-2921-9894
Giuliana TrifiròCardiovascular Genetic Centre, IRCCS, Policlinico, San Donato Milanese, Italy.ORCID http://orcid.org/0000-0001-8292-9494
Graziamaria UbertiniEndocrinology and Diabetology Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.ORCID http://orcid.org/0009-0001-2134-6639
Flavia UrbanoGiovanni XXIII Pediatric Hospital, University of Bari "Aldo Moro", Bari, Italy.ORCID http://orcid.org/0000-0002-9985-7084
Francesco VierucciPediatric Unit San Luca Hospital, Lucca, Italy.ORCID http://orcid.org/0000-0002-2192-518X
Malgorzata WasniewskaDepartment of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.ORCID http://orcid.org/0000-0002-8299-2677
Stefano MoraLaboratory of Pediatric Endocrinology, Department of Pediatrics, IRCCS Ospedale San Raffaele, Milan, Italy.ORCID http://orcid.org/0000-0002-4781-6715
Luisa de SanctisPediatric Endocrinology, Department of Public Health and Pediatrics, University of Turin, Regina Margherita Children's Hospital, Turin, Italy. luisa.desanctis@unito.it.ORCID http://orcid.org/0000-0003-2113-6196

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeChildren and adolescents frequently experience fractures related to accidental injuries; however, fractures may also result from non-accidental trauma in abused children or from underlying bone fragility due to primary or secondary osteoporosis. In pediatric patients with fragility fractures diagnosis and treatment may be delayed. This document aims to provide clinicians with a practical approach to the diagnosis and management of fragility fractures in children and adolescents.

methodsBetween November 2024 and June 2025, a group of Italian pediatric endocrinologists with expertise in bone and mineral metabolism held regular online meetings to discuss key issues related to the diagnosis and management of pediatric bone fragility and developed experts opinion statements based on clinical experience and a review of the relevant literature.

resultsThe expert panel formulated consensus statements on the clinical management of children and adolescents with fragility fractures. Seven main areas were addressed: 1) definition of fragility fractures and pediatric osteoporosis; 2) diagnostic approach; 3) main causes of primary and secondary osteoporosis; 4) assessment of the potential for spontaneous recovery from bone fragility; 5) management of bisphosphonate therapy; 6) other therapeutic options; 7) conservative measures.

conclusionThe diagnosis of osteoporosis in pediatric patients should follow a clinically oriented approach. Genetic testing plays a crucial role in identifying primary forms of osteoporosis. Vertebral reshaping may occur in some patients with secondary osteoporosis. Bisphosphonates represent the mainstay of treatment in children and adolescents with bone fragility. Conservative measures aimed at optimizing bone strength may be beneficial in selected cases.

Indexed as

AdolescentsBisphosphonatesChildrenFragility fracturesOsteoporosisVertebral reshaping

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.