Clinical Diagnosis and Treatment of Osteoporosis and Fractures

Dear Colleagues,

Osteoporosis was first recognised as a clinical entity in the mid‑20th century, when researchers described post‑menopausal bone loss and its link to vertebral and hip fractures. Subsequent decades saw the development of non‑invasive bone mineral density testing—most notably, dual‑energy X‑ray absorptiometry (DXA)—and the adoption of World Health Organization definitions for osteopenia and osteoporosis. Despite advances in imaging and pharmacotherapy, the prevalence of osteoporotic fractures continues to rise with population ageing. The emergence of tools such as the FRAX and integral approaches such as Fracture Liaison Services (FLS) has improved risk stratification, yet many patients remain undiagnosed or undertreated.

This Special Issue will provide a comprehensive platform for clinicians and researchers to address current challenges in the diagnosis and management of osteoporosis and fragility fractures. We aim to cover the full spectrum from basic pathophysiology to clinical implementation, emphasising both traditional diagnostic measures (clinical risk assessment, biochemical testing, DXA, trabecular bone scores, and FRAX) and novel precision medicine approaches such as artificial intelligence‑driven imaging analysis and proteomic biomarkers. The scope also includes prevention strategies, established and emerging pharmacologic therapies, and integrated care models for patients who have sustained fragility fractures.

Recent breakthroughs in bone health research will be highlighted. These include TBS or 3D-DXA techniques that assess bone microarchitecture; machine learning algorithms that combine imaging and clinical data to predict fracture risk; and omics‑based biomarkers (genomic, proteomic, and metabolomic signatures) that may enable personalised treatment. On the therapeutic front, anabolic agents such as romosozumab and abaloparatide, sequential therapy protocols, and regenerative strategies such as mesenchymal stem cell-based bone regeneration are transforming the management landscape. Additionally, research into patient‑centred intervention exercise regimens, nutritional optimisation, and anti‑inflammatory approaches aims to improve recovery after fractures and reduce subsequent fracture risk.

We invite the submission of original research articles, clinical trials, translational studies, and high‑quality reviews that will advance our understanding of osteoporosis and fragility fractures. Suitable topics include (but are not limited to) novel diagnostic modalities and risk assessment tools, studies on bone biology and microarchitecture, randomised controlled trials and real‑world evaluations of pharmacological agents (bisphosphonates, denosumab, teriparatide, abaloparatide, romosozumab, selective oestrogen receptor modulators, calcium/vitamin D supplementation), integrated care pathways combining medical therapy with exercise and nutritional interventions, and investigations into the molecular mechanisms underlying bone loss and repair. We also welcome systematic reviews, meta‑analyses, and interdisciplinary contributions from across the fields of geriatrics, endocrinology, orthopaedics, physiotherapy and public health.

Dr. Nicolas Martinez-Velilla
Guest Editor

Dr. Bernardo Abel Cedeño-Veloz
Dr. Jose Manuel Cancio-Trujillo
Guest Editor Assistants

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• osteoporosis
• fragility fractures
• bone mineral density (DXA)
• FRAX score
• bone turnover markers
• precision medicine
• artificial intelligence
• proteomic biomarkers
• anabolic and antiresorptive therapies
• integrated care for fracture patients