Bone turnover markers (BTMs) have been developed many years ago to study, in combination with imaging techniques,
bone remodeling in adults. In children and adolescents, bone metabolism differs from adults since it implies both growth
and bone remodeling, suggesting an age- and gender-dependent BTM concentration. Therefore, specific studies have evaluated
BTMs in not only physiological but also pathological conditions. However, in pediatrics, the use of BTMs in clinical
practice is still limited due to these many children-related specificities. This review will discuss about physiological levels
of BTMs as well as their modifications under pathological conditions in children and adolescents. A focus is also given on
analytical and clinical challenges that restrain BTM usefulness in pediatrics.