Clinical Osteology - Latest articles
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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
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
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
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
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
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
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
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
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
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
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...
Prevalence of hand osteoarthritis in NÚRCH patientsOriginal contributions
Veronika Farská, Soňa Wimmerová, Ivan Rybár
Clin Osteol 2025; 30(3): 136-144
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
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
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
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
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
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
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
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
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...