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Bone disorders such as osteoporosis, osteopenia, and osteoarthritis affect millions worldwide, creating an urgent need for earlier and more accurate assessment of bone health. High-resolution imaging has transformed this field: micro-computed tomography remains the research gold standard for ex vivo and preclinical studies, while high-resolution peripheral quantitative computed tomography enables in vivo clinical assessment of trabecular and cortical bone microarchitecture. Combined with finite element analysis and machine learning, these modalities enable biomechanical modelling, predictive risk stratification, and progress toward personalised treatment. Remaining challenges include cost, limited availability, motion artefacts, and lack of standardisation. This review summarises current advances in imaging and computational methods, highlights their respective strengths and limitations, and outlines future directions required to translate these technologies into routine clinical practice.
Lindtner et al. (2025) studied this question.