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...

Comprehensive overview of bone disease in oncology patientsMain theme

Beata Špániková

Clin Osteol 2026; 31(1): 26-34 | DOI: 10.36290/clo.2026.004

The issue of bone changes in cancer patients an interesting and important part of supportive care for cancer patients. The incidence of many cancers is increasing, thanks to advances in treatment options, many cancer patients are surviving for a long time. Decrease in bone density is often result of the cancer disease itself and/or adverse event of anticancer therapy. Therefore, solving this problem is of great importance for the quality of life of long-term survivors. In this article we present an overview of the most common skeletal complications, their underlying pathophysiological mechanisms, diagnostic and differential diagnostic and the therapeutic...

Management of osteoporosis and fracture risk in women with hormone-sensitive breast cancer treated with aromatase inhibitors: a working draft of updated clinical practice recommendationsMain theme

Dana Michalská, Martina Zimovjanová, Jana Přibylová, Dominika Svobodová, Vít Zikán

Clin Osteol 2026; 31(1): 16-24 | DOI: 10.36290/clo.2026.003

Adjuvant therapy with aromatase inhibitors (AIs) is a standard component of treatment for hormone-sensitive breast cancer; however, it is associated with accelerated bone mineral density loss and an increased risk of osteoporosis and fractures. Current international recommendations emphasize the need for systematic fracture risk assessment both at the initiation of AI therapy and throughout its course, as well as for the timely implementation of preventive and therapeutic measures. In all patients, lifestyle and nutritional interventions are recommended, including regular physical activity, adequate calcium intake, and vitamin D supplementation. Antiresorptive...

Bone mestastases - a comprehensive overviewMain theme

Martin Marhefka, Aviv Philip Goncharov, Elad Ben Aharon Farzalla, Martina Spisarová, Bohuslav Melichar

Clin Osteol 2026; 31(1): 12-15 | DOI: 10.36290/clo.2026.002

Bone is one of the organs most commonly affected in patients with cancer. The skeletal involvement can be primary or secondary (metastatic), with bone metastases present in up to 70-80 % of all malignancies. In approximately 80 % of patients, bone metastases are caused by four primary tumours: breast, lung, renal and prostatic carcinoma. That is due to both the high incidence and the preference of these tumours to invade into the skeleton. The diagnosis of bone metastases is based on the clinical presentation, laboratory parameters, and confirmatory imaging methods. Subsequent therapy which includes chemotherapy, immunotherapy, hormone therapy, supportive...

Primary bone tumours: An Orthopaedic PerspectiveMain theme

Jiří Gallo, Tomáš Tomáš

Clin Osteol 2026; 31(1): 7-11 | DOI: 10.36290/clo.2026.001

Primary bone tumors represent a heterogeneous and relatively rare group of lesions whose biological behavior ranges from benign incidental findings to highly malignant sarcomas. The WHO classification (2020) categorizes tumors according to histogenesis (osteogenic, chondrogenic, etc.); however, for clinical practice, the key distinction is between benign, intermediate (locally aggressive and, in rare cases, metastasizing), and malignant lesions. A crucial clinical task is early triage: to distinguish lesions suitable for observation or elective treatment from suspected malignancies requiring urgent further evaluation and management in a specialized...

Kostní metabolismus u chorob gastrointestinálního traktu – váhový úbytek a střevní mikrobiom v centru pozornostiEditorial

doc. MUDr. Ludmila Brunerová, Ph.D.

Clin Osteol 2025; 30(4): 187

Několik slov úvodemEditorial

Vladimír Palička

Clin Osteol 2025; 30(4): 190

Latest research and news in osteologyLiterature

Emőke Šteňová

Clin Osteol 2025; 30(4): 232-233

Biosimilar denosumab - a new chapter in the treatment of bone diseasesSaid at the congress

doc. MUDr. Karel Urbánek, Ph.D., prof. MUDr. Vladimír Palička, CSc., dr.h.c., prof. MUDr. Karel Pavelka, DrSc.

Clin Osteol 2025; 30(4): 226-231

Biosimilar medicines, which are biologically similar to the reference product, although not identical copies, reduce the cost of biological treatment and make it possible to expand the number of patients who can receive it. There is sufficient evidence that the efficacy of biosimilar medicines does not differ from that of the original biological products and that switching from the original medicine to a biosimilar, as well as between biosimilars, is not only feasible but also safe.

An unusual cause of hypercalcemia from an endocrinologist's perspectiveCase reports

Lucie Lysková, Daniela Číhalíková, David Karásek, Jaroslav Michálek

Clin Osteol 2025; 30(4): 221-224 | DOI: 10.36290/clo.2025.036

Calcium is an essential element that plays a crucial role in bone mineralization, neuromuscular transmission, and is involved in many cellular signaling processes. Its serum concentration (total albumin-corrected concentration) should range between 2.15 and 2.55 mmol/L and is strictly regulated by several mechanisms. Hypercalcemia is defined as an elevated level of serum calcium above 2.55 mmol/L. It has various causes, ranging from parathyroid gland dysfunction, most commonly in the form of primary hyperparathyroidism, through granulomatous diseases, to serious malignancies with skeletal invasion or paraneoplastic syndromes, such as ectopic production...

Bone in the gynecology clinicReview articles

Tomáš Fait, Vlasta Dvořáková

Clin Osteol 2025; 30(4): 216-220 | DOI: 10.36290/clo.2025.035

The logical reason for linking gynecology with bone health care is the importance of estrogen for achieving optimal bone density and its dominant role in the prevention of postmenopausal osteoporosis. Bone health can thus be influenced by the choice of contraception, proper care for women with premature ovarian failure, rational choice of hormone replacement therapy during menopause, and early calcium and vitamin D supplementation in women at risk of osteoporosis. The role of gynecologists in bone health care has been confirmed by their current involvement in the screening and treatment of osteoporosis as primary care physicians.

Pain management in patients with osteoporosisReview articles

Jana Hrubešová, Pavel Ryška

Clin Osteol 2025; 30(4): 210-215 | DOI: 10.36290/clo.2025.034

Osteoporosis is characterized by the loss of bone mass, increased bone fragility, and a higher risk of fractures. It can remain asymptomatic for a long time, but once musculoskeletal changes develop, pain often occurs. Pain is one of the most distressing symptoms of osteoporosis and, if not properly managed, can significantly reduce a patient's quality of life and limit their functional abilities. Effective pain management should be an essential part of a comprehensive treatment plan for patients with this condition. When standard analgesic treatments are insufficient, minimally invasive techniques may be considered, offering rapid and effective pain...

Management of osteoporosis in childrenReview articles

Ľubica Tichá, Ľudmila Podracká

Clin Osteol 2025; 30(4): 203-208 | DOI: 10.36290/clo.2025.033

Osteoporosis in childhood is a rare but serious condition characterized by reduced bone density and increased susceptibility to fractures. Primary (genetically determined) disorders account for only a small proportion of cases, while up to 98% develop secondarily in association with another underlying disease. Diagnosis is based on clinical presentation, fracture history, and measurement of bone mineral density using Dual Energy X-ray Absorptiometry (DXA). In children, it is essential to adjust the Z-score for current height to ensure accurate interpretation of the results. Treatment requires a multidisciplinary approach focused on managing the underlying...

Gut microbiome and bone: a review of current knowledgeMain theme

Ivana Cibulková

Clin Osteol 2025; 30(4): 196-201 | DOI: 10.36290/clo.2025.032

Bone metabolism is a dynamic and complex process involving a continuous cycle of bone resorption and formation. An imbalance between these processes leads to the development of osteoporosis - the most common metabolic bone disease - characterized by decreased bone mass and an increased risk of fractures, as well as other pathological conditions. While bone metabolism has traditionally been associated primarily with hormonal regulation and mechanical loading, growing evidence points to a key role of the gut microbiota in the regulation of mineralization and the maintenance of bone integrity. The microbiome influences not only intestinal homeostasis...

Bone changes after significant weight lossMain theme

Ludmila Brunerová

Clin Osteol 2025; 30(4): 191-194 | DOI: 10.36290/clo.2025.031

The impact of obesity on bone mineral density (BMD) is complex. While chronically increased skeletal loading leads to elevated BMD, especially in the axial skeleton, the presence of low-grade inflammation and frequent vitamin D deficiency can negatively affect both the quantity and quality of bone. The risk of fractures in obese patients may be increased not only due to reduced bone quality but also due to impaired balance and a higher risk of falls. The technique used to measure BMD also plays a role. The gold standard - dual-energy X-ray absorptiometry (DXA) - may overestimate BMD in obese patients due to the higher volume of adipose tissue (known...

Několik slov úvodemEditorial

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

Clin Osteol 2025; 30(3): 127

Latest research and news in osteologyLiterature

Emőke Šteňová

Clin Osteol 2025; 30(3): 182

Kam směřuje léčivý přípravek Prolia po 15 letech na českém trhu?Said at the congress

Clin Osteol 2025; 30(3): 177-181

Denosumab v léčbě osteoporózy - vysadit či pokračovatSaid at the congress

MUDr. Magdalena Agnieszka Sokalska-Jurkiewicz Ph.D.

Clin Osteol 2025; 30(3): 174-176

Nová éra v léčbě osteoporózy: Terrosa v předplněném peru dostupná i mimo specializovaná osteologická centraAdvertorial

MUDr. Hana Strnadová

Clin Osteol 2025; 30(3): 172

A case study: Diagnostic relation of Paget's disease and cardiac transthyretin amyloidosisCase reports

Filip Lukačík, Vladimíra Baarová, Klára Mátlová, Richard Pikner

Clin Osteol 2025; 30(3): 167-171 | DOI: 10.36290/clo.2025.026

Paget´s disease of bone is a metabolic bone disorder characterised by excessive bone resorption followed by an increase in bone formation of defective bone. Diagnosis is based on laboratory findings of elevated ALP, X­ray and whole body bone scintigraphy. Transthyretin amyloidosis (ATTR) of heart is a storage disease characterised by pathological deposition of transthyretin protein. Specific scintigraphic examination using 99mTc DPD is necessary to confirm ATTR or an endocardial biopsy if needed. Excessive accumulation of bone­seeking radiopharmaceuticals in the myocardium may occur during the whole body bone scintigraphy. This accumulation may point...

Differential diagnostics of back painReview articles

Richard Chaloupka, Luděk Ryba

Clin Osteol 2025; 30(3): 161-166 | DOI: 10.36290/clo.2025.025

Diagnostics of back pain consists of several levels - history, subjective, objective examination, imaging methods, laboratory tests, internal and neurological examinations. Each level has to be evaluated, and all levels have to be compared and concluded. In imaging methods we start with X-rays, anteroposterior and lateral. CT examination is indicated in skeletal pathology (especially in injuries). MRI is indicated in neural deficit, suspicion of inflammation and tumours, bone scan in suspicion of metastatic lesions. Laboratory tests: ESR, CRP, blood count help us in infections and internal examination. After diagnosis of affected level (vertebra, disc)...

Metastatic versus osteoporotic vertebral fracturesReview articles

Martin Bibza, Peter Tisovský, Boris Šteňo

Clin Osteol 2025; 30(3): 153-160 | DOI: 10.36290/clo.2025.024

Differentiating metastatic from osteoporotic vertebral fractures is clinically crucial yet challenging. We summarize key clinical and imaging "red flags" (night pain unrelieved by rest, progression, neurological deficit) and advocate a multimodal diagnostic pathway (MRI, CT; selective PET/CT use). A case initially managed as an osteoporotic fracture illustrates pitfalls of first-line interpretation and the value of image re-evaluation and comprehensive physical examination. Correct recognition of metastatic involvement enabled appropriate staging and subsequent management planning.

Chronic low-grade inflammation and primary osteoporosisReview articles

Jan Štěpán

Clin Osteol 2025; 30(3): 145-152 | DOI: 10.36290/clo.2025.023

Population aging associated with chronic low-grade inflammation and a wide range of diseases is a global public health problem. One such disease is primary osteoporosis. The quantity and quality of bone mass decreases in all people from the fourth decade. In women, this involutional bone loss can be significantly accelerated in the perimenopausal and postmenopausal periods. A decrease in bone quality and mass is associated with changes in the immune system and the persistence of chronic mild inflammation in the bone, muscle, and intestine. With the aging population, early prevention of osteoporosis and low-traumatic fractures becomes urgent. An effective...