Prevalence of hand osteoarthritis in NÚRCH patientsOriginal contributions

Veronika Farská, Soňa Wimmerová, Ivan Rybár

Clin Osteol 2025; 30(3): 136-144 | DOI: 10.36290/clo.2025.022

Objective: To determine the prevalence of clinically symptomatic hand osteoarthritis (HOA) among patients examined at NÚRCH Piešťany. Methods: The patient sample (n = 6 319) included individuals evaluated at NÚRCH Piešťany during the first half of 2019. The prevalence of clinically symptomatic HOA and radiographic involvement of specific hand joint sites were assessed, with particular attention given to erosive and trapezioscaphoid osteoarthritis. The results were statistically analyzed using Pearson correlation tests. Results: Among 6 319 outpatients, the prevalence of clinically symptomatic HOA was 15.98 % (1 010 patients). The prevalence of erosive...

Mezioborové stanovisko k bezpečnosti a efektivitě kombinované hormonální antikoncepce s denní dávkou ethinylestradiolu 20 a 30 μgMain theme

Česká gynekologicko-porodnická společnost (ČGPS ČLS JEP), Slovenská gynekologicko-porodnická společnost (SGPS) spolu se Společností pro metabolická onemocnění skeletu (SMOS), Spoločnosťou pre osteoporózu metabolické ochorenia kostí (SOMOK), prof. MUDr. Vladimír Palička, CSc., Dr.h.c.

Clin Osteol 2025; 30(3): 134 | DOI: 10.36290/clo.2025.021

Recommended dual-energy X-ray absorptiometry (DXA) bone densitometry report formatMain theme

Jan Rosa, Vladimír Palička, Vít Zikán, Petr Kasalický, František Šenk, Richard Pikner, Milan Bayer, Ladislav Bortlík, Ludmila Brunerová, Pavel Horák, Štěpán Kutílek, Václav Vyskočil

Clin Osteol 2025; 30(3): 130-133 | DOI: 10.36290/clo.2025.020

Introduction: In the last 2 years the number of DXA bone densitometry devices in the Czech Republic has increased substantially. The number of patients examined and the number of reports of individual DXA studies have increased proportionally. The accuracy and precision of the description is essential for the quality of care of patients with osteoporosis and other osteopathies. No recommended form of DXA examination report has been published in the Czech literature so far. Methods: The key items of the Recommended Format were designed and developed by the SMOS Working Group using literature search and gathering experience from established DXA centres....

Několik slov úvodemEditorial

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

Clin Osteol 2025; 30(2): 67

Latest research and news in osteologyLiterature

Emőke Šteňová

Clin Osteol 2025; 30(2): 121-122

MikroRNA ako potencionálne bioprediktory pre osteoporózuReview articles

Karolína Kubalová, Marta Mydlárová Blaščáková

Clin Osteol 2025; 30(2): 114-120 | DOI: 10.36290/clo.2025.018

Osteoporóza je celosvetovo vysoko frekventované ochorenie s vysokou morbiditou a mortalitou v dôsledku zlomenín. Príčinou osteoporózy je prevaha osteoresorpcie nad novotvorbou kostí. Štúdium nových epigenetických faktorov spojených s týmto ochorením môže rozšíriť poznatky o patogenéze a epidemiológii tohto ochorenia. Spomedzi známych epigenetických mechanizmov sú miRNA jedným z najviac študovaných regulátorov génovej expresie. miRNA majú kľúčovú úlohu pri regulácii kostnej homeostázy a metabolizme. Sú prítomné v telesných tekutinách vrátane séra, čo naznačuje, že cirkulujúce miRNA by mohli slúžiť ako jednoduché neinvazívne biomarkery pre diagnostiku...

Muscle mass of patients with rheumatoid arthritis and the effect of treatmentReview articles

Stela Kašperová, Lenka Tarabčáková, Barbora Kašperová, Mária Páterková, Emőke Šteňová

Clin Osteol 2025; 30(2): 108-113 | DOI: 10.36290/clo.2025.017

Sarcopenia is a progressive disease characterized by the loss of skeletal muscle mass, both in volume and function. Although it was originally considered a consequence of physiological ageing, it is now known to occur in connection with chronic diseases, particularly inflammatory ones. Rheumatoid arthritis is a prototype of a systemic autoimmune disease, in which there is not only joint damage but also extra-articular manifestations, including changes in body composition. Until recently, the loss of muscle mass and strength in these patients was attributed mainly to musculoskeletal dysfunction due to pain, disability, and chronic corticosteroid use....

Forestiere disease and fracture riskReview articles

Pavol Masaryk

Clin Osteol 2025; 30(2): 100-107 | DOI: 10.36290/clo.2025.016

Diffuse idiopathic skeletal hyperostosis (DISH, Forestier's disease) is a systemic non-inflammatory disease of the musculoskeletal system, causing ossification and calcification of the spinal ligaments and attachments around the joints. Although the spine appears robust with richly formed bone, it is actually more prone to fracture in individuals with DISH compared to unaffected individuals. Fractures are caused by a unique "lever-like" mechanism created by bone bridges. Spinal fractures in DISH can be easily missed with plain X-rays, so a CT or MRI scan is recommended if a fracture is suspected. Spinal bone density measured by both DXA and QCT tends...

Biosimilar denosumab CT-P41 in the treatment of osteoporosisOriginal contributions

Karel Urbánek

Clin Osteol 2025; 30(2): 96-99 | DOI: 10.36290/clo.2025.015

Denosumab is an IgG2 monoclonal antibody targeted against receptor activator of nuclear factor kappa-B (RANKL) ligand, a key regulator of bone resorption by osteocytes. Therapy with this biologic is an effective and safe treatment option for osteoporosis of various aetiologies. Denosumab CT-P41 is a biosimilar that was registered by the European Medicines Agency in March 2025 under the name Stoboclo for use in osteology. In preclinical and clinical trials, it has demonstrated quality, safety and efficacy in the treatment of bone loss comparable to the brand-name. Its introduction into clinical practice will improve the availability of expensive biological...

Treatment of osteoid osteoma in children and adolescents by radiofrequency ablationOriginal contributions

Paulína Kubičková, Jana Bevilaqua, Matúš Halas, Pavol Rendek, Milan Kokavec

Clin Osteol 2025; 30(2): 90-95 | DOI: 10.36290/clo.2025.014

Osteoid osteoma is the third most common benign bone tumor in children and adolescents. It accounts for around 11 % of benign bone tumours and 5 % of all bone tumours. It occurs typically in children and adolescents between age of 5 and 25 years, with a predominance in boys. A typical clinical symptom is nocturnal pain, which resolves after administration of aspirin or other non-steroidal anti-inflammatory drugs. In the past, except of conservative treatment, only surgical therapy available for treatment, was en bloc resection of the tumour. With science and technological progress, there is percutaneous CT-guided radiofrequency ablation. Radiofrequency...

Pseudohypoparathyroidism: case reportMain theme

Dana Michalská

Clin Osteol 2025; 30(2): 82-88 | DOI: 10.36290/clo.2025.013

Pseudohypoparathyroidism (PHP) is a rare metabolic disorder characterized by biochemical signs of hypoparathyroidism (hypocalcemia and hyperphosphatemia), increased secretion of parathyroid hormone (PTH), and resistance in target tissues to the biological action of PTH. PHP is caused by genetic or epigenetic abnormalities in the guanine nucleotide-binding protein alpha-stimulating gene (GNAS) and is classified as PHP1A or PHP1B, depending on the site of the genetic abnormality. In our case report, we publish the case of a 31-year-old man with PHP type 1B, which was diagnosed accidentally after a head injury. The patient did not have Albright...

Bone metabolism in primary hyperparathyroidismMain theme

Judita Klímová

Clin Osteol 2025; 30(2): 77-81 | DOI: 10.36290/clo.2025.012

Primary hyperparathyroidism is a generalized disorder of calcium-phosphate metabolism with an increasing incidence. Long-term overproduction of parathyroid hormone with varying degrees of hypercalcemia and hypercalciuria leads to a wide range of complications, from life-threatening hypercalcemic crisis, through diffuse kidney damage, to neurocognitive, metabolic and cardiovascular abnormalities. Bone damage, caused by the predominance of osteoresorption over new formation, is characterized by reduced bone density, impaired bone microarchitecture and an increased risk of vertebral and non-vertebral fractures. Advanced forms of bone damage with the formation...

Osteoporosis and diabetes mellitusMain theme

Ludmila Brunerová

Clin Osteol 2025; 30(2): 71-76 | DOI: 10.36290/clo.2025.011

Diabetes mellitus is associated with increased risk of osteoporotic fractures although pathophysiologic mechanisms may differ. In accordance with recent ADA/IOF updated guidelines, specific assessment of fracture risk and screening of osteoporosis should be involved in standard management of patients with diabetes. In real clinical practice, however, insufficient attention is paid to bone health in patients with diabetes. Entire diagnostic and therapeutic approaches are (with some specifics) similar to those in general population, the main difference being the therapeutic threshold (antiosteoporotic treatment should be considered in T-skóre ≤...

Výber z najnovších vedeckých informácií v osteológiiLiterature

Šteňová Ke Em

Clin Osteol 2025; 30(1): 61-62

Secondary OsteoporosisReview articles

Horák Pavel

Clin Osteol 2025; 30(1): 54-60 | DOI: 10.36290/clo.2025.009

Osteoporosis is a major public health problem. Although postmenopausal and involutional osteoporosis are the most common forms, secondary causes account for up to 30 % of osteoporosis in postmenopausal women, 50 % of premenopausal osteoporosis, and 80 % of osteoporosis in men. Causes of secondary osteoporosis include lifestyle and nutritional factors, diseases that contribute to the development of bone metabolic disorders, and iatrogenic causes related to pharmacological or nonpharmacological interventions for various conditions. The need for screening for secondary causes of osteoporosis depends on the severity of osteoporosis, the absence of obvious...

Hypophosphatasia -⁠ Standard Diagnostic and Therapeutic GuidlineReview articles

Kužma Martin, Tichá Ubica, Kokavec Milan, Payer Juraj

Clin Osteol 2025; 30(1): 48-53 | DOI: 10.36290/clo.2025.008

Hypophosphatasia (HPP) is a rare hereditary disease with a variable course, caused by mutations in the ALPL gene encoding tissue-nonspecific alkaline phosphatase (TNSALP). It is characterized by impaired bone and tooth mineralization, growth and mobility disorders, premature tooth loss, respiratory issues, and seizures. Diagnosis is based on low ALP activity and elevated levels of its substrates. Early diagnosis is crucial, as improper treatment can worsen the patient's condition. Molecular genetics can confirm the diagnosis, though it is not always necessary. Treatment includes enzyme replacement therapy and symptomatic care to manage complications.

The role of palopegteriparatide in the treatment of hypoparathyroidismReview articles

Králik Roman; Pavúková Simona; Payer Juraj; Kužma Martin

Clin Osteol 2025; 30(1): 42-45 | DOI: 10.36290/clo.2025.007

Hypoparathyroidism is a rare endocrine disorder characterized by insufficient secretion of parathyroid hormone, leading to hypocalcemia and its severe clinical consequences. While there are various etiological forms, the most common cause is post-surgical removal of the parathyroid glands, such as after total thyroidectomy. Diagnosis is based on low parathyroid hormone levels combined with hypocalcemia and other biochemical changes. Clinical manifestations range from mild neurological symptoms to life-threatening complications such as laryngospasms and cardiac arrhythmias. Long-term complications include nephrolithiasis, renal insufficiency, and alterations...

Predikcia osteoporotických zlomenín na základe intenzity signálu MR?Original contributions

Mikulová Udmila, Gičová Daša, Špakovská Tatiana, Lorinczová Zuzana, Kalafu-Tová Soňa, Blaščáková Mydlárová Marta

Clin Osteol 2025; 30(1): 36-40 | DOI: 10.36290/clo.2025.006

Selected stories from osteonephrology -⁠ an introductionMain theme

Sulková Dusilová Sylvie, Pavlíková Ladislava, Pokorná Anita, Jiráčková Jana, Hudík Filip, Malá Alena, Bílková Lenka, Matysková Michaela, Hyšpler Radomír, Šafránek Roman, Palička Vladimír

Clin Osteol 2025; 30(1): 30-34 | DOI: 10.36290/clo.2025.005

Vybrané příběhy z osteonefrologie -⁠ úvod do problematikySo called osteonephrology deals with the interface between metabolic and other consequences of complex bone and cardiovascular disease in renal disease and also with non-renal metabolic osteopathies in kidney patients.The article focuses on problems associated with biologic therapy of osteoporosis in patients with chronic kidney disease, including dialysis as well as kidney transplantation. The attention is paid not only to benefit of this therapy, but also on its possible risk, showing the importance of carefull monitoring in hands of nephrologists.

Vitamin D -⁠ current overview of the issue and specifics in nephrological practiceMain theme

Sulková Dusilová Sylvie, Šafránek Roman, Pavlíková Ladislava, Pokorná Anita, Kadlec Mirko, Hudík Filip, Horáček Jiří, Hyšpler Radomír, Palička Vladimír

Clin Osteol 2025; 30(1): 22-29 | DOI: 10.36290/clo.2025.004

Recent randomized placebo-controlled trials did not demonstrate clear clinical benefits of nutritional vitamin D supplementation in non-selected population. Therefore, current recommendations suggest testing vitamin D serum values only in vitamin D deficiency risk groups of patients. Kidney disease patients are at this risk.Target serum calcidiol (25-hydroxyvitamin D) concentrations in kidney disease or failure and also in kidney transplant patients should be higher than 75 nmol/l. The reason for this target is to maintain sufficient calcitriol to suppress early parathyroid gland overactivity. On the contrary, calcidiol values over 50 nmol/l are...

From despair to results: Clinical experience and effective strategies in the treatment of calciphylaxisMain theme

Krošlák Oliver, Sulková Dusilová Sylvie, Šafránek Roman, Halouzka Tomáš, Pokorná Anita, Chrobok Viktor, Horáček Jiří, Pavlíková Ladislava, Palička Vladimír

Clin Osteol 2025; 30(1): 14-20 | DOI: 10.36290/clo.2025.003

Calciphylaxis (CUA) represents a rare but serious complication in patients with chronic kidney disease and less frequently in other conditions. The aim of our study is to assess our experiences with the diagnosis and treatment of CUA. We present the clinical characteristics, the prevalence of key risk factors, and the favorable prognosis of patients with calciphylaxis treated at our institution between 2014 and 2021. The cohort consisted of 23 patients who were diagnosed with calciphylaxis based on clinical presentation. In most cases, the lesions were multiple, painful, and led to significant mobility limitations. Important risk factors included the...

A completely now approach to the issue of bone disease in patients with chronic kidney disease -⁠ what KDIGO practice recommendations can we expect? Commentary on the KDIGO 2025 Controversies Conference.Main theme

Palička Vladimír, Sulková Dusilová Sylvie

Clin Osteol 2025; 30(1): 6-12 | DOI: 10.36290/clo.2025.002

In 2006, the KDIGO initiative acknowledged the link between cardiovascular damage and bone disorders by incorporating a so called "vascular component" into the CKD-MBD concept. However, renal osteodystrophy continued to be viewed as a distinct and specific bone pathology within nephrology.In recent years, this perspective has begun to shift. Renal osteodystrophy, traditionally the domain of nephrologists, and osteoporosis, the domain of osteologists, are now increasingly converging and overlapping. The impetus for this change came from new insights into the importance of bone densitometry in nephrology and the high fracture risk among nephrology...

Několik slov úvodemEditorial

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

Clin Osteol 2025; 30(1): 3

Výber z najnovších vedeckých informácií v osteológiiLiterature

Šteňová Ke Em

Clin Osteol 2024; 29(4): 157-158

COVID-19 treatment and glucocorticoid-induced osteoporosis: a case reportCase reports

Štambera Dalibor

Clin Osteol 2024; 29(4): 151-156 | DOI: 10.36290/clo.2024.020

This case report describes the case of a patient treated with glucocorticoids in connection with his COVID-19 disease, who was subsequently diagnosed with glucocorticoid-induced osteoporosis (GIOP), the most common type of secondary osteoporosis today, based on densitometric findings and a history of low-strain fracture. The article highlights the need for preventive vitamin D and calcium supplementation during glucocorticoid treatment and also the need to perform whole-body densitometry at prescribed intervals in accordance with relevant recommendations.

Charcot's osteoarthropathy or Sudeck's Syndrome? A case reportCase reports

Novák Vladimír

Clin Osteol 2024; 29(4): 147-150 | DOI: 10.36290/clo.2024.019

A patient (born in 1950), was examined for suspicion of Sudeck's syndrome of the left foot. The problems arose after prolonged work in the garden -⁠ significant pain in the instep and sole, sensitivity to touch, swelling and redness up to the ankles. There was no previous fracture or other trauma, in the pre-illness the patient was fully mobile without support. Due to the sixteen-year history of type 2 diabetes mellitus, we considered Charcot's osteoarthro­pathy in the differential diagnosis; Subsequently, three-phase skeletal scintigraphy and MRI of the left foot were compatible with this diagnosis, as they showed pathologically increased activity...

The fragile beauty of bone -⁠ a perspective on fracture risk assessment in clinical practice: a case reportCase reports

Killinger Zdenko

Clin Osteol 2024; 29(4): 143-146 | DOI: 10.36290/clo.2024.018

In Blahoš's lecture, the author points out several aspects of bone quality and the possibilities of their use, not only when determining the risk of fracture, but also when deciding on the need for anti-porotic therapy. Briefly documents the development of diagnostic methods and therapeutic approaches in the last 30 years of Slovak osteology. Author focused on the role of bone densitometry in the diagnostic and therapeutic algorithm and progress in the position of DXA in real practice in the Slovak Republic in the given period. In conclusion, the author on a specific case report pointed out how individual bone quality parameters can influence the decision...

What's (new) in the guidelines of the osteological societies of the German-speaking countries published in 2023Comments

Hess Zdeněk

Clin Osteol 2024; 29(4): 136-142

The 2023 guidelines from German-speaking scientific osteological societies offer updated recommendations for osteoporosis prevention, diagnosis, and treatment, focusing on new risk factors, such as humeral fractures, cardiac and renal insufficiency, and chronic hyponatremia. The guidelines also consider additional factors, like immobility and HIV, and newly define bone density thresholds for initiating treatment. Romosozumab has been added as a therapeutic option to reduce the risk of vertebral and non-vertebral fractures. The improved fracture risk calculator now combines the two strongest risk factors with bone density measurements and shortens the...

Hemophilia and bone tissue metabolismReview articles

Palička Vladimír; Horáčková Jana; Pavlíková Ladislava; Hyšpler Radomír

Clin Osteol 2024; 29(4): 132-135 | DOI: 10.36290/clo.2024.016

Findings of reduced bone mineral density and osteoporosis in hemophilia patients are gradually increasing and will certainly increase with successful treatment and increasing life expectancy. Older, not very numerous studies are being replaced by large meta-analyses showing significant reduction of bone mineral density in hemophiliacs. However, it is not only the effect of increasing age that is being demonstrated, but also the direct and indirect pathobiochemical links between coagulation factor deficiency and the effect of their therapeutic administration on bone tissue metabolism. A crucial role is played by the influence of the RANK/RANKL/OPG system...

Osteoporosis and liver diseasesReview articles

Košcál Mojmír

Clin Osteol 2024; 29(4): 128-131 | DOI: 10.36290/clo.2024.015

Increasing attention to the interaction between liver and bone has stimulated interest in targeted interventions for various forms of osteoporosis. Liver damage induced by various liver diseases can cause imbalances in bone metabolism, suggesting a new regulatory paradigm between liver and bone. However, the role of the liver in the development of osteoporosis is still not well understood. Therefore, investigating the precise regulatory mechanisms (liver-bone) may offer innovative clinical approaches to treat liver and bone-related diseases.