Clinical integration of trabecular bone score in precision osteoporosis care: a position statement by the Egyptian academy of bone and muscle health

The relationship between the 2nd metacarpal index and bone mineral density for osteopenia/osteoporosis screening: a systematic review

The importance of adhering to standardized protocols and continuously refining measurement approaches to enhance reliability of 2MCI as screening tool for either osteopenia or osteoporosis is highlighted.

Bone Health Index (BHI): a Fracture Risk Assessment tool in Children with Osteogenesis Imperfecta.

The study indicates that lower BHI SDS values are associated with increased fracture risk in children with classical OI and indicates that BHI may represent a clinically useful complementary tool for fracture risk stratification in young children with OI, particularly where DXA is unavailable or technically limited, including infancy.

Evaluation of the relationship between automated software-derived bone health index and dual-energy x-ray absorptiometry-measured bone mineral density in chinese children with chronic illness.

Purpose Children with chronic illness are vulnerable to compromised bone health. Dual-energy X-ray absorptiometry (DXA) is commonly used for assessment but has limitations related to body size adjustments and positioning, highlighting the need for accessible alternatives. This study evaluated the correlation between the Bone Health Index (BHI), derived from automated hand radiograph analysis, and areal bone mineral density (BMD) measured by DXA in Chinese children with chronic illness. Methods In this retrospective study, Chinese children undergoing simultaneous DXA and hand radiography were included. Correlations between BHI metrics and DXA-derived BMD Z-scores were assessed. Results A total of 327 patients were analyzed. Absolute BHI values showed negligible correlation with DXA-derived BMD at the lumbar spine (LS) (r = 0.10, p = 0.05) and total body less head (TBLH) (r = 0.00, p = 0.35). BHI standard deviation scores (SDS) exhibited moderate positive correlations with DXA BMD Z-scores (LS: r = 0.42, p <0.001; TBLH: r = 0.43, p <0.001). In steroid-treated patients, these correlations were weaker (LS: r = 0.30, p =0.007; TBLH: r = 0.30, p 0.001). Conversely, steroid-naïve patients exhibited stronger correlations (LS: r = 0.48, p<0.001; TBLH: r = 0.53, p<0.001). Conclusion In steroid-treated patients, BHI SDS correlated weakly with DXA-derived BMD Z-scores, whereas steroid-naïve patients exhibited moderate correlations. This highlights that BHI and DXA BMD assess distinct bone properties that are differentially influenced by systemic treatment like glucocorticoids. Consequently, BHI should be regarded as a complementary tool rather than serving as a direct surrogate for DXA.

Nails in osteoporosis and bone metabolism: a narrative review of current evidence and future directions

Trabecular bone score and bone mineral density in systemic sclerosis: Prevalence of low bone quality and associated clinical factors - a case-control study.

The trabecular bone score (TBS) provides complementary, indirect information on trabecular microarchitecture that may be independently impaired in SSc, and SSc patients exhibit significantly impaired bone microarchitecture compared with matched controls.

Cortical Indices, DXA, and FRAX as Indicators of Bone Fragility: A Comparative Human Cadaveric Study

Osteoporosis is a progressive skeletal disorder characterized by reduced bone mineral density (BMD) and increased risk of fragility fractures. Clinical assessment relies primarily on dual-energy X-ray absorptiometry (DXA) and the Fracture Risk Assessment Tool (FRAX), but limited access and low screening rates motivate investigation of complementary approaches. This human cadaveric study evaluated cortical indices of the second metacarpal, radius, and femur in relation to DXA-based osteoporosis status and biomechanically derived fracture susceptibility at the wrist and hip. Cortical measurements were obtained from 39 donor-matched forearms and femurs categorized as normal (n = 8), osteopenic (n = 11), and osteoporotic (n = 20) based on femoral neck DXA T-score. Simulated fall testing of the distal radius and proximal femur was performed to determine work to fracture, which was used to derive low and high biomechanical fracture susceptibility classifications. Among the cortical indices, metacarpal cortical index (MCI) demonstrated the strongest associations with DXA T-scores and biomechanical outcomes. MCI distinguished normal from osteoporotic classification at the femoral neck (area under the curve (AUC) = 0.938) and 1/3 radius (AUC = 0.986). For biomechanically derived fracture susceptibility, femoral neck T-score demonstrated strong discrimination at both the femur (AUC = 0.917) and wrist (AUC = 0.851), while MCI yielded AUCs of 0.847 and 0.855, respectively. FRAX hip fracture (HF) probability yielded AUCs of 0.911 at the femur and 0.830 at the wrist. These findings demonstrate associations between MCI, DXA-based osteoporosis status, and biomechanical fracture susceptibility in this cadaveric cohort. MCI may therefore warrant further investigation as a complementary screening approach, particularly where access to DXA is limited. Validation in larger clinical cohorts with prospective fracture outcomes is needed to determine its clinical utility.