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Clin Osteol 2026; 31(Suppl.A)

Od stratifikace rizik k inovaci léčby osteoporózy u pacientů s vysokým rizikem zlomeninySaid at the congress

MUDr. Zuzana Zafarová

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

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

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...

Technické pokroky v diagnostice osteoporózyMain theme

MUDr. Petr Kasalický, CSc.

Clin Osteol 2026; 31(3): 126

Několik slov úvodemEditorial

Vladimír Palička

Clin Osteol 2026; 31(3): 123

Latest research and news in osteologyLiterature

Emőke Šteňová

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

Preparing a patient with osteoporosis for orthopedic surgeryReview articles

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.

Systemic lupus erythematosus and fracture riskReview articles

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...

Artificial intelligence: an introduction and its applications in osteologyMain theme

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...

Computed tomography and opportunistic osteoporosis screeningMain theme

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...

The role of nuclear medicine in metabolic bone diseasesMain theme

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...

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

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...

Kost a hormonální vlivy v průběhu životaMain theme

prof. MUDr. Tomáš Fait, Ph.D.

Clin Osteol 2026; 31(2): 72

Několik slov úvodemEditorial

prof. MUDr. Vladimír Palička, CSc., Dr.h.c.

Clin Osteol 2026; 31(2): 71

Latest research and news in osteologyLiterature

Emőke Šteňová

Clin Osteol 2026; 31(2): 117-118

Lesions of the anterior cruciate ligament in children and adolescentsReview articles

Matúš Halas, Pavol Rendek, Paulína Kubíčková, Jana Bevilaqua, Martina Frištáková, Milan Kokavec

Clin Osteol 2026; 31(2): 111-115 | DOI: 10.36290/clo.2026.017

Anterior cruciate ligament (ACL) injuries in children and adolescents are among the most common types of knee injuries associated with dynamic sports activities. Incorrect treatment and inappropriate choice of surgical technique can lead to further damage to the knee joint, possibly to the development of secondary osteoarthritis. This work is based on the author's dissertation and the aim of this work is to summarize current knowledge and options for surgical treatment of ACL lesions in children and adolescents.

Spinal fractures in ankylosing spondylitisReview articles

Luděk Ryba, Richard Chaloupka, Dominik Parížek

Clin Osteol 2026; 31(2): 105-110 | DOI: 10.36290/clo.2026.016

Ankylosing spondylitis (AS, Morbus Bechterew) is a chronic inflammatory disease of the axial skeleton leading to progressive spinal ankylosis and secondary osteoporosis. The combination of a rigid spine and impaired bone quality markedly increases the risk of spinal fractures, which often occur even after low-energy trauma. These fractures are typically highly unstable, involve all three spinal columns, and are associated with a significant risk of neurological complications and increased mortality. Conservative treatment is frequently burdened by secondary displacement and failure of immobilization, therefore surgical stabilization represents the...

The impact of patient adherence on the efficacy of osteoporosis pharmacotherapyOriginal contributions

Mária Kolesárová, Ľudmila Pavlíková, Dana Marcinčáková, Zuzana Mačeková, Dalibor Kolesár, Ladislav Seman, Ján Kyselovič

Clin Osteol 2026; 31(2): 97-104 | DOI: 10.36290/clo.2026.015

Background: Clinical trials demonstrate that osteoporosis pharmacotherapy reduces fracture incidence by approximately 50%. However, this therapeutic benefit may be severely compromised by sub-optimal patient adherence in real-world clinical practice. The primary objective of this retrospective study was to evaluate the long-term efficacy of osteoporosis pharmacotherapy and assess patient adherence levels using the ADEOS-12 questionnaire, with a specific focus on analysing the correlation between adherence scores and objective clinical outcomes, including bone mineral density (BMD) and biochemical bone turnover markers. Methods: Medication adherence...

Gynecologists in caring for bone health in women with breast cancerMain theme

Stefánia Faitová, Tomáš Fait

Clin Osteol 2026; 31(2): 91-96 | DOI: 10.36290/clo.2026.014

Breast cancer is the most common malignancy in women. Therapeutically induced hypoestrogenism may lead to significant bone loss and a consequent increase in fracture risk. Antiresorptive treatment of osteoporosis (bisphosphonates and denosumab) plays an important role in mitigating bone loss induced by anticancer therapy. Currently, evidence supports the use of bisphosphonates as adjuvant therapy to prevent metastasis and recurrence of the disease. Unfortunately, bone health care in women with breast cancer is often not prioritized, leaving this group of patients vulnerable to significant bone loss and subsequent fractures.

Anorexia nervosa and bone healthMain theme

Pavla Jelínková

Clin Osteol 2026; 31(2): 87-90 | DOI: 10.36290/clo.2026.013

Mental anorexia represents a serious psychiatric disorder with significant somatic complications. One of the most serious is a disorder of bone metabolism leading to a decrease in bone mineral density, disruption of bone microarchitecture, and an increased risk of fractures. Adolescence is a critical period for the accumulation of bone mass and the achievement of peak bone density. Energy deficit and hormonal dysregulation lead to disruption of the physiological process of bone formation and remodeling, resulting in a lifelong increased risk of osteoporosis. The aim of this review article is to summarize current knowledge on the pathophysiology of...

Tibolone and the bone healthMain theme

Tomáš Fait

Clin Osteol 2026; 31(2): 84-86 | DOI: 10.36290/clo.2026.012

Hormone replacement therapy is the most effective treatment for acute climacteric syndrome and prevention of chronic changes from estrogen deficiency. Tibolone as a selective regulator of tissue estrogenic activity is the only alternative of comparable efficacy with an excellent safety profile. It achieves better results in the area of influencing the psyche and sexuality of postmenopausal women and in some safety parameters (reduces mammographic density). Its effect on bone health is comparable to hormone replacement therapy.

Menopausal hormone therapy and bone healthMain theme

Lukrécia Tatárová

Clin Osteol 2026; 31(2): 78-82 | DOI: 10.36290/clo.2026.011

Menopause is a physiological phase in a woman's life that is associated not only with the occurrence of vasomotor and urogenital symptoms, but also with significant long term health consequences, particularly affecting skeletal, cardiovascular, and cognitive health. Declining estrogen levels lead to accelerated bone loss, which may result in the development of osteoporosis. Menopausal hormone therapy (MHT) represents the most effective treatment for vasomotor symptoms and the genitourinary syndrome of menopause, while also serving as an effective strategy for the prevention of postmenopausal bone loss. Numerous randomized controlled trials and metaanalyses...

Progestin only contraception and bone healthMain theme

Vlasta Dvořáková

Clin Osteol 2026; 31(2): 76-77 | DOI: 10.36290/clo.2026.010

Progestin only contraception is often chosen for women with a higher cardiovascular risk. The intrauterine system with levonorgestrel is completely neutral to bone metabolism. Progestin only pills with desogestrel or drospirenone also have no negative effect on bone health. In contrast the use of depot medroxyprogesterone acetate reduces bone mineral density.

Onkologie a kostMain theme

prof. MUDr. Pavel Horák, CSc.

Clin Osteol 2026; 31(1): 06

Několik slov úvodemEditorial

prof. MUDr. Vladimír Palička, CSc., Dr.h.c.

Clin Osteol 2026; 31(1): 03

Latest research and news in osteologyLiterature

Emőke Šteňová

Clin Osteol 2026; 31(1): 65-66

Diagnosis and treatment of osteoporotic vertebral fracturesReview articles

Martin Bibza, Michal Božík, Mário Malina, Boris Šteňo

Clin Osteol 2026; 31(1): 55-64 | DOI: 10.36290/clo.2026.008

Osteoporotic vertebral compression fractures represent the most common clinical manifestation of osteoporosis and a major cause of morbidity in the elderly population. Successful management requires accurate identification of fractures, differentiation between acute and chronic fractures, assessment of stability, and comprehensive evaluation of functional status and frailty. The AO Spine-DGOU classification and Osteoporotic Fracture (OF) score provide a structured framework for assessing fracture morphology and guide decision-making between conservative treatment and surgical procedures. Conservative therapy is appropriate for stable fractures without...

Importance of B vitamins for the neuromusculoskeletal systemReview articles

Milan Grofik, Katarína Kramár

Clin Osteol 2026; 31(1): 49-52 | DOI: 10.36290/clo.2026.007

The B vitamins represent a chemically heterogeneous group of eight hydrophilic essential compounds. In the human body, they play an important role as coenzymes in various cellular reactions. The B vitamins have long been known for their irreplaceable role in the proper functioning of the nervous system, but in recent years, scientific knowledge has been increasing supporting their important role in maintaining the physiological functions of the muscular and skeletal systems. They are also necessary for adequate regeneration of damaged musculoskeletal tissues in various disease states. Data from "Evidence-Based Medicine" postulate them as effective...

An optimized protocol for RNA and microRNA isolation from human mineralized femoral neck bone tissueOriginal contributions

Květa Vrablíková, Marcela Slavíčková, Helena Párová, Petr Hoza

Clin Osteol 2026; 31(1): 45-48 | DOI: 10.36290/clo.2026.006

Low-trauma proximal femur fractures are among the most serious complications of osteoporosis. MicroRNAs regulate bone remodeling and cellular senescence, yet extracting high-quality RNA from mineralized human bone remains technically challenging and insufficiently standardized. This study aimed to develop and optimize a reproducible protocol for collecting and processing femoral neck bone biopsies obtained during total hip arthroplasty, enabling isolation of total RNA including the small RNA fraction (< 200 nt) and subsequent targeted expression analysis of specific microRNAs. Forty-six patients were enrolled (21 osteoporotic fractures, 25 osteoarthritis)....

Tumor-induced osteomalacia - a rare cause of hypophosphatemia in patients at an osteology clinicMain theme

Henrieta Halmová, Filip Halm, Peter Sečník, Andrej Vondrák, Ján Koreň, Mojmír Ducár

Clin Osteol 2026; 31(1): 36-44 | DOI: 10.36290/clo.2026.005

Tumour-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused by benign tumours of the mesenchymal origin. It is characterized by the excessive production of fibroblast growth factor 23 (FGF23), which subsequently leads to hypophosphatemia and osteomalacia. In the article, we present a case report of the 57-year-old female patient who, after a relatively protracted diagnostic process, was diagnosed with TIO caused by the benign tumor of mesenchymal origin, called sinonasal glomangiopericytoma. In this case report, we further discuss the pathophysiology of a hypophosphatemic osteomalacia, its differential diagnosis and the treatment options...