Artificial-Intelligence

DXA bone density misses many people who go on to fracture, and in some fracture liaison services up to 30% report too little DXA access. This Nature Reviews Rheumatology review, written under a WHO Collaborating Centre, surveys the single-component tools that add to it or stand in for it: heel and pulse-echo ultrasound, REMS, trabecular bone score, finite element analysis, 3D shape modelling from DXA, and AI that reads bone density and vertebral fractures from routine X-rays and CT. Trabecular bone score and REMS are the best established. The harder questions now are validation across populations, calibration, equity of access and whether the tools relieve DXA services.

A population-based MRI study of 11,163 German adults found sacroiliac joint bone marrow oedema in about one in three people — roughly 50 times the prevalence of axial spondyloarthritis. The signal tracked with BMI, occupational loading, age and, in women, pregnancy, while chronic back pain barely moved the rate, providing the missing denominator for interpreting a positive SIJ MRI.