Harnessing Biophysical Approaches in Unlocking Bone Health: A Toolkit for Clinicians and Researchers

The skeletal system exhibits remarkable mechanical properties, serving as the primary supportive framework in vertebrates. Dysregulation of bone metabolic activity can alter bone quality and quantity, leading to skeletal deformity, pain, or disease. Accurate assessment, therefore, necessitates robust methods capable of evaluating both mechanical competence and structural characteristics across various scales. Numerous bone assessment techniques have been developed to comprehensively assess these parameters ex vivo and increasingly in situ. We discuss a spectrum of modalities, including mechanical testing, radiological imaging, microscopic, and spectroscopic analysis, evaluating their operational principles, applications in understanding bone health and pathophysiology, inherent advantages, and current limitations. Notably, we also highlight how a synergistic combination of two or more techniques provides information exceeding the capabilities of individual methods alone and hence advance our understanding for future diagnostic avenues. Integration of artificial intelligence (AI) further holds considerable potential to augment the analytical prowess of these methods, offering enhanced insights for decision-making. By elucidating these robust methodologies, we aim to expand the understanding of bone health and disease, with implications for improved patient management and treatment strategies. This review consolidates a spectrum of interconnected bone assessment techniques, each offering unique insights and collectively enabling diverse modalities for opportunistic screening of skeletal disorders in an aging global population.