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

Assessment of Bone Mass and Fracture Risk Using Trabecular Bone Score in Children with Autoimmune Gastrointestinal Diseases

The findings suggest that the clinical role of TBS in the assessment of pediatric bone health remains to be established, and that larger prospective studies are needed to clarify the clinical value of TBS for fracture risk assessment in pediatric autoimmune gastrointestinal diseases.

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

Osteoporosis screening is essential for early intervention and fracture prevention. While dual-energy X-ray absorptiometry (DXA) remains the gold standard for bone mineral density (BMD) assessment, alternative, cost-effective methods are being explored. Radiogrammetry (DXR) has shown promising results; however, it needs specialized computer software. Hand radiographs, particularly the second metacarpal cortical index (2MCI), have shown promise in BMD evaluation. This study aims to systematically review the evidence on the diagnostic accuracy of the 2nd MCI in assessing BMD. A systematic search of PubMed, Scopus, and EMBASE databases was conducted on May 6, 2025, to identify observational and diagnostic accuracy studies evaluating the relationship between the 2MCI and BMD in adults aged 50 years and older. Case reports and non-English studies were excluded. Data extraction followed PRISMA guidelines, and study quality was assessed using QUADAS-2. Due to heterogeneity in study designs, a narrative synthesis was performed. Six studies with a total of 1028 participants were included. Findings consistently demonstrated that 2MCI radiographs correlate with BMD. In addition, machine learning models enhanced the predictive performance of the 2MCI. However, accuracy of findings particularly sensitivity and specificity remains variable in identifying osteopenia or osteoporosis. This study highlights 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. With improved study designs, it further strengthens the clinical applicability of these findings.

Bone health assessment in children with osteogenesis imperfecta from Bone health assessment in children with osteogenesis imperfecta from a pediatric endocrinology perspective a pediatric endocrinology perspective

Fracture risk prediction based on multivariable diagnostic models incorporating dual-energy X-ray absorptiometry based bone mineral density, trabecular bone score, and clinical risk factors in women aged ≥ 50 years: a prospective study

Indirect bone microarchitecture analysis using DXA-derived TBS predicts fragility fracture risk independently of spine BMD and with comparable predictive performance in postmenopausal women in Poland.

Bone health assessment in children with osteogenesis imperfecta from a pediatric endocrinology perspective

Objective: Osteogenesis imperfecta (OI) is an uncommon hereditary disorder of connective tissue that results in fragile bones due to abnormalities in collagen structure. This study aimed to evaluate bone health in children with OI who were hospitalized for fracture treatment. Materials and Methods: This retrospective observational study reviewed the records of children aged 3–18 years and diagnosed with OI and hospitalized in the pediatric orthopedics ward for fractures between May 1, 2023, and January 31, 2026. The patients’ demographic characteristics, biochemical parameters, bone mineral density (BMD) Z-scores, vertebral radiographs, vitamin D levels, sun exposure, and treatment status were evaluated. Results: A total of 37 patients participated in the study. The average age of the patients was 10.35±3.82 years, and 78.4% were male. Mean BMD Z-score was -1.44±1.61. Vertebral fractures were present in 27% of the patients. Significant differences were observed between groups stratified by vitamin D levels for age (p = 0.020), serum calcium (p = 0.003), phosphorus (p = 0.005), alkaline phosphatase (p = 0.027), parathyroid hormone (p = 0.018), and BMD Z-score (p = 0.023). Patients with vitamin D deficiency showed lower serum calcium levels and BMD Z-scores. Additionally, a statistically significant positive correlation was identified between BMD Z-score and serum calcium levels (r=0.343; p=0.038). Conclusion: Evaluation of skeletal health in children with OI should not rely solely on BMD measurements; vertebral fractures, biochemical markers, growth, and environmental factors should also be considered. Collaboration between pediatric orthopedics and pediatric endocrinology is vital for better long-term outcomes.

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

Dual-energy X-ray absorptiometry (DXA)-derived bone mineral density (BMD) has long been the gold standard for osteoporosis diagnosis, yet its inability to account for bone quality leads to a significant “sensitivity gap” in fracture risk prediction. This position paper presents an up-to-date review of the evidence base, which informs the implementation of Trabecular Bone Score (TBS) in clinical practice. 2. This review explores the paradigm shift toward a dual Quantity + Quality model in bone health assessment, centred on the TBS. Databases including PubMed/MEDLINE, Embase, Scopus, and the Cochrane Library were queried using a combination of MeSH terms and keywords. The evolution of TBS from a basic texture index to an AI-driven spatial mapping tool (TBS-Reveal) was examined. The integration of TBS into the FRAX algorithm significantly improves the identification of high-risk individuals within the “osteopenic grey zone”. Furthermore, TBS provides critical diagnostic clarity in secondary osteoporosis, such as Type 2 Diabetes and Primary Hyperparathyroidism, where BMD often remains paradoxically high despite severe microarchitectural decay. Technical advancements, including direct soft tissue thickness correction and the renormalized L1-only model, have enhanced accuracy in complex patients with high BMI or degenerative spinal disease. Trabecular Bone Score is no longer an optional research tool but a clinical necessity. By analyzing the variogram of the DXA image, TBS allows clinicians to see “the architecture of resilience” within the bone. Its seamless integration into the clinical workflow is essential for the delivery of proactive, personalized, and precision osteoporosis management.