Bone Abstracts

Background: Osteoporosis remains underdiagnosed, and public awareness of care pathways is variable. Patients attending orthopaedic services may represent a subpopulation in whom bone health is clinically relevant, particularly where surgical outcome may be influenced by bone quality. Assessing awareness and prior assessment in this setting may inform future case-finding strategies.

Aims: To describe osteoporosis awareness, prior assessment, and understanding of screening pathways among adults undergoing hip and pelvic radiography in an orthopaedic outpatient setting.

Methods: Adults aged ≥50 attending an NHS orthopaedic outpatient clinic and undergoing hip or pelvic radiography were recruited into a prospective study evaluating opportunistic bone health assessment from routine imaging using the AI-based tool OsteoSight™. Participants completed a structured bone health awareness questionnaire incorporating a modified Osteoporosis Knowledge Assessment Tool (OKAT), prior DXA testing, and self-rated understanding of osteoporosis. Responses were analysed descriptively.

Results: A total of 95 participants were included in the analysis. The mean age was 68.7 years (range 5190), and 57% were female. 86 (91.5%) out of 94 respondents reported no previous osteoporosis screening (e.g. DXA). 90 (96.8%) out of 93 respondents were not aware of NHS eligibility criteria for osteoporosis screening. Self-rated knowledge or understanding of osteoporosis from 0 to 10 was low (mean 2.74, standard deviation 2.42). Similarly, the modified OKAT questionnaire demonstrated low knowledge of osteoporosis across 55 respondents (mean 4.22, standard deviation 2.27, min 0, max 9; scores out of 20).

Conclusion: In this small prospective study of AI-enabled opportunistic bone health assessment, awareness of osteoporosis and prior screening were limited despite participants being engaged with orthopaedic care, where bone health may have immediate clinical relevance. These findings indicate an unmet need in a clinically important population and suggest that opportunistic case-finding approaches could support earlier identification of individuals requiring bone health assessment. Further research is needed to determine how such strategies could be integrated into musculoskeletal care pathways.