The demand for bone mineral assessments in pediatrics has grown in the past decade. This trend likely reflects greater awareness of the importance of early bone health for osteoporosis prevention (1),(2). An estimated 60% of the variable risk of osteoporosis has been attributed to the magnitude of peak bone mass reached by early adulthood; the remaining 40% is explained by subsequent bone loss. Genetic factors, undernutrition, hormone disorders, medications, immobilization, and chronic illness during childhood and adolescence may compromise the rate at which bone size, mineral content, and quality are accrued (1–(3). If not reversed, this results in reduced peak bone, increasing the lifetime risk of osteoporotic fracture. In severely affected children, low-impact or fragility fractures can begin in childhood.