BoneScore study draws sold-out crowd at ASBMR 2026

A Washington University researcher presented NIH-funded BoneScore findings to a sold-out bone-quality symposium at ASBMR 2026 in Boston, highlighting early evidence that the technology measures bone quality beyond density. The presentation built on a peer-reviewed cadaver study and previewed expanded donor data and spinal surgery research.

Why it matters: - Fragility fractures often happen in people whose bone density is not in the osteoporotic range. - BoneScore is designed to measure bone material strength directly, which may help identify risk that DXA bone density misses. - The work could affect how clinicians assess fracture susceptibility and surgical bone strength.

What happened: - Simon Y. Tang, PhD, of Washington University School of Medicine in St. Louis presented BoneScore research at the American Society for Bone and Mineral Research 2026 Annual Meeting in Boston. - Tang spoke to a sold-out bone-quality symposium. - The presentation built on a peer-reviewed cadaver study published in July in Clinical Orthopaedics and Related Research®. - BoneScore said the Boston presentation highlighted the science behind the procedure, from bone material strength measurement to lab testing of whole bones and early spinal screw fixation work.

The details: - In the published CORR study, researchers measured Bone Material Strength index, or BMSi, at the shin in 67 female donors. - The team then broke each donor’s hip, wrist, and spine bones in the laboratory and compared those results with DXA bone density. - BMSi correlated with femur strength at r = 0.62, compared with r = 0.45 for total hip bone density. - Using an estimated sideways-fall load, BMSi separated femurs that failed from those that held, with AUC 0.75. - Total hip bone density did not separate those groups well, with AUC 0.62 and p = 0.08. - In donors with osteopenia or normal density, BMSi still tracked femur strength, with r = 0.61 and r = 0.58. - Total hip density did not track femur strength in those groups. - Adding BMSi to total hip density nearly doubled the share of femur strength explained, from 28% to 52%. - At the wrist, BMSi matched total hip bone density, with AUC 0.77 for BMSi and AUC 0.78 for total hip BMD. - In bone specimens, BMSi correlated with fracture toughness at r = 0.83. - Rachana S. Vaidya, PhD, first author of the study, led the analyses. - The authors concluded that BMSi provides complementary information to BMD and captures aspects of bone quality that cannot be measured clinically without destructive testing. - Tang previewed preliminary results from an expanded cohort of 116 donors that includes men. - In that expanded work, Tang compared BMSi with hip DXA and FRAX, the standard fracture-risk calculator. - Tang said BMSi remained a strong discriminator in non-osteoporotic donors, while BMD accuracy dropped and FRAX did not appear to work in that group. - Tang also described early laboratory work on spinal surgery, where screw loosening can lead to repeat operations. - Surgeons often use CT scans, measured in Hounsfield Units, to judge how vertebral bone will hold a screw. - In pull-out tests, CT worked well for clearly strong or clearly weak bone, but bone in the middle range was harder to classify. - Measuring BMSi at the screw site helped distinguish vertebrae that looked similar on CT but held screws differently. - Tang said the next step is figuring out how to integrate BoneScore with other measures and which patient groups benefit most. - BoneScore reports results as BMSi from a single reading at the shin. - The procedure uses an FDA-cleared device and is available by prescription in the United States. - The device is CE-marked in Europe and the United Kingdom. - A Category III CPT code, 0547T, has been established for impact microindentation. - Coverage and payment are set separately by payers and are not guaranteed. - Physicians can learn more at more information. - The study used deceased female donors, so the authors said the results reflect the intrinsic mechanical competence of bone rather than dynamic fracture risk in living individuals. - Prospective clinical studies are the next step. - The expanded cohort and spine work previewed in Boston are supported by NIH grant R44AG071034.

Between the lines: - The ASBMR presentation suggests BoneScore is moving from proof-of-concept toward broader clinical positioning. - The strongest signal in the study is not that BoneScore replaces bone density, but that it may add information where density alone falls short. - The spinal screw work points to a possible orthopedic use case beyond fracture prediction, especially when imaging leaves a gray zone. - The NIH support and the sold-out symposium signal growing scientific interest, but the data shared in Boston were still preliminary.

What's next: - Researchers plan to analyze the expanded 116-donor cohort that includes men. - The team will continue comparing BMSi with DXA and FRAX in people without osteoporosis. - Further lab work will test whether BMSi can improve decision-making in spinal surgery. - Future prospective clinical studies will need to determine how well BoneScore performs in living patients and whether it changes care.

The bottom line: - BoneScore is emerging as a potential complement to bone density testing, with early data suggesting it may better capture bone quality in some patients and settings.