Osteoporosis is often undiagnosed due to the shortcomings of conventional screening, resulting in missed chances for early treatment. Advances in artificial intelligence (AI), particularly deep learning applied to chest X-rays, offer a new opportunity for opportunistic screening. This study assesses the cost-effectiveness of this approach in Japanese women aged ≥ 50 years.
Methods
An economic model estimated the cost per quality-adjusted life year (QALY) gained (in 2024 Japanese Yen, ¥) for a strategy involving AI-assisted chest X-ray screening followed by treatment, compared to no screening. Patient trajectories were modeled using the AI system's diagnostic performance and aligned with the Japanese osteoporosis guidelines. Analyses were conducted for Japan overall, in Kure City (a high-fracture-incidence area), and in a lower-incidence scenario. Real-world medication persistence, the probabilities of dual-energy X-ray absorptiometry examination after screening detection, and treatment initiation rates were incorporated.
Results
Nationwide in Japan, the cost per QALY gained from opportunistic osteoporosis screening was estimated at ¥189,713 for women aged ≥ 50, substantially lower than the accepted cost-effectiveness threshold of ¥5 million. In Kure City, opportunistic screening was dominant (lower total costs for more QALYs). In the lower-incidence scenario, 25% below the national average, the cost per QALY was ¥1,055,095, remaining below the threshold. Results were robust across all age-specific populations and in sensitivity analyses.
Conclusions
Leveraging AI-assisted chest X-rays for incidental osteoporosis detection demonstrates strong economic viability for older Japanese women. This approach also proves to be a dominant strategy in areas with elevated fracture rates.
{"title":"Cost-effectiveness of opportunistic osteoporosis screening using artificial-intelligence assisted chest radiographs in Japan","authors":"Jean-Yves Reginster , Takahiko Hamasaki , Saeko Fujiwara , Majed Alokail , Mickael Hiligsmann","doi":"10.1016/j.afos.2025.10.003","DOIUrl":"10.1016/j.afos.2025.10.003","url":null,"abstract":"<div><h3>Objectives</h3><div>Osteoporosis is often undiagnosed due to the shortcomings of conventional screening, resulting in missed chances for early treatment. Advances in artificial intelligence (AI), particularly deep learning applied to chest X-rays, offer a new opportunity for opportunistic screening. This study assesses the cost-effectiveness of this approach in Japanese women aged ≥ 50 years.</div></div><div><h3>Methods</h3><div>An economic model estimated the cost per quality-adjusted life year (QALY) gained (in 2024 Japanese Yen, ¥) for a strategy involving AI-assisted chest X-ray screening followed by treatment, compared to no screening. Patient trajectories were modeled using the AI system's diagnostic performance and aligned with the Japanese osteoporosis guidelines. Analyses were conducted for Japan overall, in Kure City (a high-fracture-incidence area), and in a lower-incidence scenario. Real-world medication persistence, the probabilities of dual-energy X-ray absorptiometry examination after screening detection, and treatment initiation rates were incorporated.</div></div><div><h3>Results</h3><div>Nationwide in Japan, the cost per QALY gained from opportunistic osteoporosis screening was estimated at ¥189,713 for women aged ≥ 50, substantially lower than the accepted cost-effectiveness threshold of ¥5 million. In Kure City, opportunistic screening was dominant (lower total costs for more QALYs). In the lower-incidence scenario, 25% below the national average, the cost per QALY was ¥1,055,095, remaining below the threshold. Results were robust across all age-specific populations and in sensitivity analyses.</div></div><div><h3>Conclusions</h3><div>Leveraging AI-assisted chest X-rays for incidental osteoporosis detection demonstrates strong economic viability for older Japanese women. This approach also proves to be a dominant strategy in areas with elevated fracture rates.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"11 4","pages":"Pages 127-136"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Atypical femoral fractures (AFFs) are a rare but serious complication of prolonged anti-resorptive therapy for osteoporosis. This study aimed to develop consensus-based recommendations for the clinical management of AFFs across the Asian Federation of Osteoporosis Societies (AFOS), for harmonizing practice and improving patient outcomes.
A structured questionnaire covering ten key domains related to AFFs was distributed to expert representatives from the 10 AFOS member countries or regions. Responses were analyzed to identify areas of consensus and variation in regional practice. A concurrent narrative review of the literature was conducted to inform evidence-based recommendations.
Survey responses were obtained from 8 of 10 participating AFOS member nations or regions. Among these, Thailand, Malaysia, South Korea, and Hong Kong reported established national guidelines or position statements on AFFs. Contributing risk factors include extended anti-resorptive therapy, femoral geometry, comorbidities, and specific pharmacologic exposures. Diagnosis depends on clinical suspicion and multimodal imaging, with high concordance in diagnostic criteria across regions. Screening emphasizes full-length femoral imaging in high-risk individuals. Incomplete AFFs are managed conservatively or with prophylactic fixation, while complete AFFs typically require intramedullary nailing, tailored to anatomic variations such as femoral bowing. Post-fracture care involves discontinuation of anti-resorptives, assessment for secondary osteoporosis, and potential initiation of anabolic therapy, including teriparatide, abaloparatide, and romosozumab.
This AFOS-led initiative highlights the importance for early detection, individualized management, and region-specific strategies. A multidisciplinary, patient-centered approach—encompassing risk assessment, imaging surveillance, surgical intervention, and tailored pharmacologic treatment—is crucial to reduce AFFs impact and improve skeletal health outcomes across Asia.
{"title":"Asian Federation of Osteoporosis Societies 2025 consensus on atypical femoral fractures in patients with osteoporosis","authors":"Thanut Valleenukul , Thawee Songpatanasilp , Unnop Jaisamrarn , Surapong Anuraklekha , Varalak Srinonprasert , Sumapa Chaiamnuay , Aasis Unnanuntana , Lalita Wattanachanya , Hataikarn Nimitphong , Noratep Kulachote , Ong-art Phruetthiphat , Rahat Jarayabhand , Tanawat Amphansap , Ekasame Vanitcharoenkul , Pojchong Chotiyarnwong , Satoshi Mori , Kwang-kyoun Kim , Swan Sim Yeap , Sharmila Sunita Paramasivam , Linsey Gani , Natthinee Charatcharoenwitthaya","doi":"10.1016/j.afos.2025.11.001","DOIUrl":"10.1016/j.afos.2025.11.001","url":null,"abstract":"<div><div>Atypical femoral fractures (AFFs) are a rare but serious complication of prolonged anti-resorptive therapy for osteoporosis. This study aimed to develop consensus-based recommendations for the clinical management of AFFs across the Asian Federation of Osteoporosis Societies (AFOS), for harmonizing practice and improving patient outcomes.</div><div>A structured questionnaire covering ten key domains related to AFFs was distributed to expert representatives from the 10 AFOS member countries or regions. Responses were analyzed to identify areas of consensus and variation in regional practice. A concurrent narrative review of the literature was conducted to inform evidence-based recommendations.</div><div>Survey responses were obtained from 8 of 10 participating AFOS member nations or regions. Among these, Thailand, Malaysia, South Korea, and Hong Kong reported established national guidelines or position statements on AFFs. Contributing risk factors include extended anti-resorptive therapy, femoral geometry, comorbidities, and specific pharmacologic exposures. Diagnosis depends on clinical suspicion and multimodal imaging, with high concordance in diagnostic criteria across regions. Screening emphasizes full-length femoral imaging in high-risk individuals. Incomplete AFFs are managed conservatively or with prophylactic fixation, while complete AFFs typically require intramedullary nailing, tailored to anatomic variations such as femoral bowing. Post-fracture care involves discontinuation of anti-resorptives, assessment for secondary osteoporosis, and potential initiation of anabolic therapy, including teriparatide, abaloparatide, and romosozumab.</div><div>This AFOS-led initiative highlights the importance for early detection, individualized management, and region-specific strategies. A multidisciplinary, patient-centered approach—encompassing risk assessment, imaging surveillance, surgical intervention, and tailored pharmacologic treatment—is crucial to reduce AFFs impact and improve skeletal health outcomes across Asia.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"11 4","pages":"Pages 111-120"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.afos.2025.10.004
Iris Paola Guzmán-Guzmán , José Rafael Villafan-Bernal , Ilse Adriana Gutiérrez-Pérez , Ramcés Falfán-Valencia , Héctor Ugo Rojas-Delgado , Antonio Alarcón-Paredes , Andrés Felipe Villaquiran-Hurtado , Gustavo Adolfo Alonso-Silverio , Oscar Zaragoza-García
Objectives
Sarcopenia and sarcopenic obesity are associated with a depletion of muscle mass, strength, and performance in rheumatoid arthritis (RA). We aimed to determine the prevalence of sarcopenia and sarcopenic obesity, as well as the clinical factors.
Methods
A cross-sectional study was carried out with 262 patients suffering from RA (230 women and 32 men). Demographic data, anthropometric measurements, clinical features, and previous medication were recorded. Sarcopenia was defined based on the 2019 consensus of the Asian Working Group for Sarcopenia. The combination of sarcopenia and an excess of body fat mass was classified as sarcopenic obesity. Multivariable-adjusted regression analysis was used to explore potential factors associated with sarcopenia phenotypes in RA patients.
Results
Among the study participants, 49.6% had sarcopenia; of those, 66.9% had sarcopenic obesity. Subjects with sarcopenia were significantly older, had a longer duration of illness, more morning stiffness, higher radiological grade, and elevated erythrocyte sedimentation rate levels. Additionally, female sex and the use of combinations of disease-modifying antirheumatic drugs were significantly more common in the sarcopenia group compared to patients without sarcopenia (all P < 0.05).
Conclusions
The prevalence of sarcopenia and sarcopenic obesity is high among Mexican patients with RA, and the current study shows that sarcopenia phenotypes are linked to worse functional impairment and significantly higher joint damage score. Early detection, nutritional intervention, and treatment of muscle dysfunction could enhance the quality of life and outcomes for RA patients.
{"title":"Sarcopenia and sarcopenic obesity in rheumatoid arthritis patients: prevalence and their relationship with joint damage and functional impairment","authors":"Iris Paola Guzmán-Guzmán , José Rafael Villafan-Bernal , Ilse Adriana Gutiérrez-Pérez , Ramcés Falfán-Valencia , Héctor Ugo Rojas-Delgado , Antonio Alarcón-Paredes , Andrés Felipe Villaquiran-Hurtado , Gustavo Adolfo Alonso-Silverio , Oscar Zaragoza-García","doi":"10.1016/j.afos.2025.10.004","DOIUrl":"10.1016/j.afos.2025.10.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Sarcopenia and sarcopenic obesity are associated with a depletion of muscle mass, strength, and performance in rheumatoid arthritis (RA). We aimed to determine the prevalence of sarcopenia and sarcopenic obesity, as well as the clinical factors.</div></div><div><h3>Methods</h3><div>A cross-sectional study was carried out with 262 patients suffering from RA (230 women and 32 men). Demographic data, anthropometric measurements, clinical features, and previous medication were recorded. Sarcopenia was defined based on the 2019 consensus of the Asian Working Group for Sarcopenia. The combination of sarcopenia and an excess of body fat mass was classified as sarcopenic obesity. Multivariable-adjusted regression analysis was used to explore potential factors associated with sarcopenia phenotypes in RA patients.</div></div><div><h3>Results</h3><div>Among the study participants, 49.6% had sarcopenia; of those, 66.9% had sarcopenic obesity. Subjects with sarcopenia were significantly older, had a longer duration of illness, more morning stiffness, higher radiological grade, and elevated erythrocyte sedimentation rate levels. Additionally, female sex and the use of combinations of disease-modifying antirheumatic drugs were significantly more common in the sarcopenia group compared to patients without sarcopenia (all P < 0.05).</div></div><div><h3>Conclusions</h3><div>The prevalence of sarcopenia and sarcopenic obesity is high among Mexican patients with RA, and the current study shows that sarcopenia phenotypes are linked to worse functional impairment and significantly higher joint damage score. Early detection, nutritional intervention, and treatment of muscle dysfunction could enhance the quality of life and outcomes for RA patients.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"11 4","pages":"Pages 145-151"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.afos.2025.10.002
Yuko Fujiwara , Toshifumi Fujiwara , Seiichi Kamo
Objectives
In the context of Japan's rapidly aging population, osteoporotic vertebral fractures are becoming increasingly prevalent, creating greater demands for rehabilitation amid healthcare labor shortages. This study aimed to evaluate the feasibility and potential efficacy of abdominal electrical muscle stimulation (EMS) as an adjunct to rehabilitation in older adults with osteoporotic vertebral fractures, focusing on muscle thickness and bowel function.
Methods
Thirty-four elderly patients (mean age: 85 years) hospitalized for osteoporotic vertebral fractures underwent conventional physical and occupational therapy combined with abdominal EMS four times per week. Rectus abdominis muscle thickness was assessed by ultrasound, and bowel function was evaluated using bowel movement frequency and laxative usage. Interrater reliability for ultrasound measurement was high (ICC = 0.97; 95% CI: 0.90–0.99).
Results
Rectus abdominis muscle thickness increased significantly by 0.5 mm (P = 0.001). A non-significant trend toward increased spontaneous bowel movements was observed (5–6 times/week; P = 0.058), and laxative use decreased significantly (P = 0.0172). No EMS-related adverse events were reported, and all participants completed the intervention as scheduled.
Conclusions
Abdominal EMS is a feasible, safe, and potentially effective adjunct to conventional rehabilitation for older adults with osteoporotic vertebral fractures, even during periods of bed rest. It may contribute to muscle maintenance and support bowel function. These findings support further investigation in larger prospective studies to confirm efficacy and explore long-term outcomes.
{"title":"Feasibility and tolerability of electrical muscle stimulation during rehabilitation in older adults with osteoporotic vertebral fractures","authors":"Yuko Fujiwara , Toshifumi Fujiwara , Seiichi Kamo","doi":"10.1016/j.afos.2025.10.002","DOIUrl":"10.1016/j.afos.2025.10.002","url":null,"abstract":"<div><h3>Objectives</h3><div>In the context of Japan's rapidly aging population, osteoporotic vertebral fractures are becoming increasingly prevalent, creating greater demands for rehabilitation amid healthcare labor shortages. This study aimed to evaluate the feasibility and potential efficacy of abdominal electrical muscle stimulation (EMS) as an adjunct to rehabilitation in older adults with osteoporotic vertebral fractures, focusing on muscle thickness and bowel function.</div></div><div><h3>Methods</h3><div>Thirty-four elderly patients (mean age: 85 years) hospitalized for osteoporotic vertebral fractures underwent conventional physical and occupational therapy combined with abdominal EMS four times per week. Rectus abdominis muscle thickness was assessed by ultrasound, and bowel function was evaluated using bowel movement frequency and laxative usage. Interrater reliability for ultrasound measurement was high (ICC = 0.97; 95% CI: 0.90–0.99).</div></div><div><h3>Results</h3><div>Rectus abdominis muscle thickness increased significantly by 0.5 mm (P = 0.001). A non-significant trend toward increased spontaneous bowel movements was observed (5–6 times/week; P = 0.058), and laxative use decreased significantly (P = 0.0172). No EMS-related adverse events were reported, and all participants completed the intervention as scheduled.</div></div><div><h3>Conclusions</h3><div>Abdominal EMS is a feasible, safe, and potentially effective adjunct to conventional rehabilitation for older adults with osteoporotic vertebral fractures, even during periods of bed rest. It may contribute to muscle maintenance and support bowel function. These findings support further investigation in larger prospective studies to confirm efficacy and explore long-term outcomes.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"11 4","pages":"Pages 152-158"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.afos.2025.11.002
Ming-Hung Chiang , Tian-Sin Fan , Chia-Che Lee , Tzu-Hao Tseng , Hung-Kuan Yen , Chih-Chien Hung , Yi-Chien Lu , Ning-Huei Sie , Chen-Yu Wang , Shau-Huai Fu
Objectives
The effectiveness of combining romosozumab (ROMO) with denosumab (Dmab) remains uncertain. We compare the six-month effects of Dmab plus monthly ROMO versus Dmab plus daily teriparatide (TPTD) on bone mineral density (BMD) in treatment-naïve postmenopausal women with osteoporosis.
Methods
This retrospective cohort study analyzed 26 treatment-naïve postmenopausal women with primary osteoporosis. Participants received either a monthly regimen of ROMO and Dmab (N = 14) or a daily regimen of TPTD plus Dmab (N = 12). BMD at the lumbar spine, total hip, and femoral neck was measured at baseline, 3 months, and 6 months by dual-energy X-ray absorptiometry. Serum levels of C-terminal telopeptide (CTX) and procollagen type I N-terminal propeptide (P1NP) were assessed at the same intervals.
Results
Both regimens significantly improved lumbar spine BMD at 6 months (ROMO + Dmab: +9.75%; TPTD + Dmab: +7.42%). Improvements in total hip and femoral neck BMD were modest and similar between groups (∼2%). Serum CTX and P1NP were significantly suppressed in both groups at 3 months, but P1NP suppression waned in the TPTD + Dmab group by 6 months. No statistically significant differences in BMD or marker changes were detected between the two regimens.
Conclusions
Both combination therapies effectively improve lumbar spine BMD over 6 months. The ROMO + Dmab regimen yielded numerically greater increases with fewer injections.
{"title":"Preliminary analysis of combined romosozumab and denosumab versus teriparatide and denosumab on bone mineral density","authors":"Ming-Hung Chiang , Tian-Sin Fan , Chia-Che Lee , Tzu-Hao Tseng , Hung-Kuan Yen , Chih-Chien Hung , Yi-Chien Lu , Ning-Huei Sie , Chen-Yu Wang , Shau-Huai Fu","doi":"10.1016/j.afos.2025.11.002","DOIUrl":"10.1016/j.afos.2025.11.002","url":null,"abstract":"<div><h3>Objectives</h3><div>The effectiveness of combining romosozumab (ROMO) with denosumab (Dmab) remains uncertain. We compare the six-month effects of Dmab plus monthly ROMO versus Dmab plus daily teriparatide (TPTD) on bone mineral density (BMD) in treatment-naïve postmenopausal women with osteoporosis.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed 26 treatment-naïve postmenopausal women with primary osteoporosis. Participants received either a monthly regimen of ROMO and Dmab (N = 14) or a daily regimen of TPTD plus Dmab (N = 12). BMD at the lumbar spine, total hip, and femoral neck was measured at baseline, 3 months, and 6 months by dual-energy X-ray absorptiometry. Serum levels of C-terminal telopeptide (CTX) and procollagen type I N-terminal propeptide (P1NP) were assessed at the same intervals.</div></div><div><h3>Results</h3><div>Both regimens significantly improved lumbar spine BMD at 6 months (ROMO + Dmab: +9.75%; TPTD + Dmab: +7.42%). Improvements in total hip and femoral neck BMD were modest and similar between groups (∼2%). Serum CTX and P1NP were significantly suppressed in both groups at 3 months, but P1NP suppression waned in the TPTD + Dmab group by 6 months. No statistically significant differences in BMD or marker changes were detected between the two regimens.</div></div><div><h3>Conclusions</h3><div>Both combination therapies effectively improve lumbar spine BMD over 6 months. The ROMO + Dmab regimen yielded numerically greater increases with fewer injections.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"11 4","pages":"Pages 137-144"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although osteoporosis affects approximately 15.9 million people in Japan, screening rates remain low. Dental panoramic radiographs (DPRs), routinely used in general dental practice, may facilitate opportunistic screening, yet referrals based on these images are not widely implemented. This study evaluated referral rates to orthopedic departments of patients with suspected osteoporosis identified using DPRs.
Methods
Among 3237 female patients aged ≥ 50 who underwent DPRs between February 2022 and October 2024, 328 without a prior osteoporosis diagnosis were identified as suspected cases. Their primary dentists referred these patients to our hospital's orthopedic department. Additionally, trained oral radiologists optionally provided information on osteoporosis. We assessed (1) the overall referral rate, (2) differences in referral rates based on whether an explanation by oral radiologist was provided, (3) referral rates stratified by age group, and (4) the prevalence of osteoporosis, osteopenia, and asymptomatic vertebral fractures among referred patients.
Results
Of the 328 patients, 53 (16.2%) visited the orthopedic department. Referral rates were significantly higher among patients who received explanations from trained oral radiologists (50.9%) than among patients who did not (9.1%). Referral rates peaked among patients in their 60s (23.7%). Among referred patients, 60.4% were diagnosed with osteoporosis and 37.7% with osteopenia; five patients had asymptomatic vertebral fractures.
Conclusions
Despite easy access to orthopedic care, referral rates remained low, likely due to limited awareness. Explanations by trained oral radiologists significantly improved referral rates, highlighting the importance of dentist-led education and interdisciplinary collaboration in promoting osteoporosis screening in general dental practice.
{"title":"Orthopedic referral rates following osteoporosis screening using dental panoramic radiography in female patients: A three-year prospective study","authors":"Noriyuki Sugino , Hiroko Kuroiwa , Hizuru Osanai , Shinichiro Yamada , Kozue Mori , Hirokazu Kobayashi , Daisuke Higuchi , Nobuyuki Udagawa , Akira Taguchi","doi":"10.1016/j.afos.2025.10.001","DOIUrl":"10.1016/j.afos.2025.10.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Although osteoporosis affects approximately 15.9 million people in Japan, screening rates remain low. Dental panoramic radiographs (DPRs), routinely used in general dental practice, may facilitate opportunistic screening, yet referrals based on these images are not widely implemented. This study evaluated referral rates to orthopedic departments of patients with suspected osteoporosis identified using DPRs.</div></div><div><h3>Methods</h3><div>Among 3237 female patients aged ≥ 50 who underwent DPRs between February 2022 and October 2024, 328 without a prior osteoporosis diagnosis were identified as suspected cases. Their primary dentists referred these patients to our hospital's orthopedic department. Additionally, trained oral radiologists optionally provided information on osteoporosis. We assessed (1) the overall referral rate, (2) differences in referral rates based on whether an explanation by oral radiologist was provided, (3) referral rates stratified by age group, and (4) the prevalence of osteoporosis, osteopenia, and asymptomatic vertebral fractures among referred patients.</div></div><div><h3>Results</h3><div>Of the 328 patients, 53 (16.2%) visited the orthopedic department. Referral rates were significantly higher among patients who received explanations from trained oral radiologists (50.9%) than among patients who did not (9.1%). Referral rates peaked among patients in their 60s (23.7%). Among referred patients, 60.4% were diagnosed with osteoporosis and 37.7% with osteopenia; five patients had asymptomatic vertebral fractures.</div></div><div><h3>Conclusions</h3><div>Despite easy access to orthopedic care, referral rates remained low, likely due to limited awareness. Explanations by trained oral radiologists significantly improved referral rates, highlighting the importance of dentist-led education and interdisciplinary collaboration in promoting osteoporosis screening in general dental practice.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"11 4","pages":"Pages 121-126"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.afos.2025.08.007
Nick Tran , Dinh T. Nguyen , Thach S. Tran , Tuan V. Nguyen
{"title":"“Skeletal Age” for cumulative impact of cigarette smoking on post-fracture mortality","authors":"Nick Tran , Dinh T. Nguyen , Thach S. Tran , Tuan V. Nguyen","doi":"10.1016/j.afos.2025.08.007","DOIUrl":"10.1016/j.afos.2025.08.007","url":null,"abstract":"","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"11 3","pages":"Page 3"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.afos.2025.08.030
Tomomi Hata , Yukinori Tsukuda , Tomokazu Nakamura , Ayana Sato , Ryo Mitsuta , Norimasa Iwasaki
{"title":"Investigation of the utility of our clinical pathway for proximal femoral fractures in terms of treatment outcomes and continuity: Effectiveness of the FLS coordinators","authors":"Tomomi Hata , Yukinori Tsukuda , Tomokazu Nakamura , Ayana Sato , Ryo Mitsuta , Norimasa Iwasaki","doi":"10.1016/j.afos.2025.08.030","DOIUrl":"10.1016/j.afos.2025.08.030","url":null,"abstract":"","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"11 3","pages":"Page 10"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Differing mechanisms of anabolic effects between Teriparatide and Romosozumab: A bone histomorphometric assessment","authors":"Noriaki Yamamoto , Kimihiko Sawakami , Kei Watanabe , Kazuhiro Hasegawa , Taketoshi Shimakura , Hideaki E. Takahashi","doi":"10.1016/j.afos.2025.08.008","DOIUrl":"10.1016/j.afos.2025.08.008","url":null,"abstract":"","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"11 3","pages":"Page 3"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145047772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.afos.2025.08.009
Thach S. Tran , Nick Tran , Tuan V. Nguyen
{"title":"“Postponement of Fracture” as a novel metric for expressing anti-fracture efficacy: An IPD meta-analysis","authors":"Thach S. Tran , Nick Tran , Tuan V. Nguyen","doi":"10.1016/j.afos.2025.08.009","DOIUrl":"10.1016/j.afos.2025.08.009","url":null,"abstract":"","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"11 3","pages":"Page 3"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145047773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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