Několik slov úvodem

Vladimír Palička

Clin Osteol 2026; 31(3): 123

Technické pokroky v diagnostice osteoporózy

MUDr. Petr Kasalický, CSc.

Clin Osteol 2026; 31(3): 126

The FRAX^® 10-year fracture risk calculator. History and current status worldwide and in the Czech Republic

Jan Rosa

Clin Osteol 2026; 31(3): 127-134 | DOI: 10.36290/clo.2026.019

Introduction: BMD, as measured by DXA bone densitometry, is a sufficiently specific but insufficiently sensitive tool in relation to osteoporotic fractures. Incorporating other risk factors for osteoporotic fractures into the diagnostic process and treatment decision-making is essential from both clinical and pharmacoeconomic perspectives. Methods: Literature review. Results: The FRAX® web-based calculator, introduced in 2008, quantifies the 10-year risk of hip fracture and major osteoporotic fractures. Prediction is enhanced by incorporating mortality data. It can also be used based on a summary of clinical risk factors; it is not necessary to...

The role of nuclear medicine in metabolic bone diseases

Adriana Šimánková, Milan Šimánek, Daniela Šimánková

Clin Osteol 2026; 31(3): 135-142 | DOI: 10.36290/clo.2026.020

Metabolic bone diseases comprise a heterogeneous group of disorders characterized by abnormalities of bone turnover, mineralization or bone quality. Clinical, laboratory and densitometric methods remain the cornerstone of diagnosis. However, nuclear medicine imaging can provide valuable information regarding complications, extent of skeletal involvement and differential diagnosis of metabolic and neoplastic skeletal processes. Bone scintigraphy using osteotropic radiopharmaceuticals, currently most often combined with hybrid SPECT/CT imaging, represents the principal nuclear medicine modality. A characteristic finding in several metabolic bone diseases...

Computed tomography and opportunistic osteoporosis screening

David Girsa, Hana Malíková

Clin Osteol 2026; 31(3): 143-148 | DOI: 10.36290/clo.2026.021

Osteoporosis is a serious health problem associated with a high risk of fractures, morbidity, and mortality. Although population-based screening using clinical examination, the "Fracture Risk Assessment Tool" questionnaire, and bone densitometry (DXA) was introduced in the Czech Republic in 2023, some patients remain undiagnosed. One way to improve early diagnosis is through opportunistic screening, i.e., the use of CT scans already performed for other indications. CT scans contain information on bone density, which can be obtained by measuring the CT attenuation of trabecular bone-most commonly in the L1 vertebral body-expressed in Hounsfield units...

Artificial intelligence: an introduction and its applications in osteology

David Zogala

Clin Osteol 2026; 31(3): 149-152 | DOI: 10.36290/clo.2026.022

Artificial intelligence (AI) in healthcare has moved from a research topic into routine clinical and administrative practice. This is not a new concept: medicine has used algorithms, scoring systems, expert rules and computer-assisted decision support for decades. What has changed, however, is the acceleration of computing power, the improved ability of deep neural networks to process images, and the emergence of large language models, which have made generative AI accessible to the general public without technical expertise. In osteology, AI is used mainly for automated analysis of imaging data, opportunistic screening for osteoporosis from CT and...

Systemic lupus erythematosus and fracture risk

Pavol Masaryk

Clin Osteol 2026; 31(3): 153-159 | DOI: 10.36290/clo.2026.023

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease associated with persistent systemic inflammation, organ damage, cumulative exposure to glucocorticoids, and frequent comorbidities (vitamin D deficiency, renal involvement, premature menopause, low physical activity). These factors contribute to disturbances in bone metabolism, a reduction in bone mineral density (BMD), and an increased risk of both vertebral and non-vertebral fractures. Osteoporosis is the second most common comorbidity in SLE. Its prevalence is several times higher compared with the healthy population. Vertebral fractures are often asymptomatic, remain undiagnosed...

Preparing a patient with osteoporosis for orthopedic surgery

Olga Růžičková

Clin Osteol 2026; 31(3): 160-166 | DOI: 10.36290/clo.2026.024

Osteoporosis is one of the most common metabolic bone diseases and has a significant impact on the outcomes of orthopedic surgery. Reduced bone quality increases the risk of perioperative complications, implant failure, delayed healing, and subsequent revision procedures. Preoperative preparation of patients with osteoporosis therefore requires a comprehensive approach, including assessment of bone metabolism, optimization of pharmacotherapy, nutritional support, fall prevention, and multidisciplinary collaboration.

Management of patients at very high fracture risk: a revolutionary shift in osteology and new clinical strategies

MUDr. Kamila Kotíková

Clin Osteol 2026; 31(3): 167-168

This article summarizes key insights presented by Professor Michael McClung at the World Congress on Osteoporosis (WCO-IOF-ESCEO 2026) regarding the management of patients at very high risk of fracture. The work reflects a revolutionary shift in treatment strategy, wherein osteoanabolic therapies (teriparatide, romosozumab) are becoming first-line treatments aimed at rapidly restoring bone microarchitecture and increasing bone mineral density (BMD). The text introduces the concept of a "bone attack," likening a new fracture to a myocardial infarction and necessitating urgent therapeutic intervention. Furthermore, emphasis is placed on the correct treatment...

Od stratifikace rizik k inovaci léčby osteoporózy u pacientů s vysokým rizikem zlomeniny

MUDr. Zuzana Zafarová

Clin Osteol 2026; 31(3): 169-176

Latest research and news in osteology

Emőke Šteňová

Clin Osteol 2026; 31(3): 177-178