Osteoporosis in the young is overall a relatively infrequent clinical situation, and its diagnosis needs careful assessment of the affected person. The emphasis in the assessment of bone health is gradually shifting from a simple quantitative assessment of bone mineral density to one that is more fracture centric. This may be particularly important in the young adult, where the aetiological cause of osteoporosis may be a primary genetic condition or secondary to another chronic condition.

Recent international guidance issued by the International Society of Clinical Densitometry places focus on fragility fractures especially vertebral fractures for the diagnosis of osteoporosis in the young. A consideration of the fracture characteristics is also important especially in the context of a known underlying chronic disorder with known insult to the skeleton.

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