Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was a global pandemic where infected individuals experienced mild or severe disease. Unfortunately, some patients who experienced severe disease also had lasting abnormalities. The lung microbiome of 38 adult coronavirus disease 2019 (COVID-19) patients with persistent respiratory symptoms and/or radiological abnormalities was analysed. The aim was to investigate whether the lasting radiological abnormalities reported in this cohort were associated with an altered airway. Thirty-six bronchoalveolar lavage fluid samples from patients underwent 16S rRNA gene amplicon sequencing and were compared to 28 non-fibrotic control samples from a previously published study. COVID-19 patients had statistically significantly greater number of genera but at uneven abundances, though not statistically significant compared to non-fibrotic controls. Permutational ANOVA (PERMANOVA) suggested that COVID-19 can influence the lung microbiome composition after accounting for multivariate dispersion. Further analysis showed differences in the relative abundances of Actinomyces, Neisseria, Haemophilus, Rothia and Gemella. Indicator species analysis showed that a COVID-19 lung microbiome profile could be driven in part by differences in Fusobacterium, Actinomyces, Catonella, Oribacterium and Mycobacterium. Associations with clinical parameters were lacking apart from CT lung opacification, which revealed a significant negative association with the number of genera. Differential abundance analysis with MaAsLin2 pointed towards Porphyromonas as a potential explaining genus, though this was not significant after post hoc corrections. DESeq2 revealed enriched oral taxa in the BAL samples, suggesting potential oral-translocation reflective of a disease state. Our findings suggest that individuals with persistent radiological abnormalities following SARS-CoV-2 infection have experienced subtle shifts in their microbiome profile, but these are not strongly associated with clinical phenotypes and, therefore, unlikely of significance.
HER2-positive (HER2+) breast cancer (BC) is associated with a high incidence of brain metastases (BMs), which negatively affect prognosis and quality of life. Local therapies, such as whole-brain radiotherapy (WBRT), stereotactic radiotherapy, stereotactic radiosurgery, and neurosurgery, allow temporary control of metastatic spread. Systemic treatments are limited by the blood-brain barrier (BBB), which restricts the passage of many therapeutic molecules. Research initially focused on small molecule tyrosine kinase inhibitors due to their low molecular weight. Recent evidence suggests that tumor-induced disruption of the BBB may increase its permeability, potentially allowing larger molecules, including antibody-drug conjugates, to cross. Although trastuzumab deruxtecan (T-DXd) has demonstrated intracranial activity, evidence of durable complete responses in heavily pretreated patients with active BMs remains limited. We report a case of a HER2+ BC patient with multiple (>20) active BMs, previously treated with WBRT and trastuzumab emtansine (T-DM1), who developed intracranial progression. Third-line treatment with T-DXd resulted in a complete radiological intracranial response, which has been maintained for more than 20 months under ongoing therapy, with associated improvement in neurological symptoms and quality of life. This case provides preliminary evidence that T-DXd may achieve deep and durable intracranial responses even in heavily pretreated patients with active BMs, including those previously treated with WBRT and T-DM1. The exceptional duration of response observed in this case appears to exceed historical expectations and warrants further investigation in this high-risk population.
Polycythemia is a condition with abnormal increase in red blood cell mass and number in circulation. Increased attenuation with diffuse involvement of Circle of Willis and cerebral venous sinuses mimicking a contrast enhanced study is one of the early noncontrast CT findings in polycythemia. It can mimic venous sinus thrombosis which is its complication and thus warrants further imaging studies. Further imaging studies are needed for the dense vessel appearance in NCCT where the CT number is above a threshold value.
Gastric varices represent a challenging clinical scenario due to the severity of consequences when bleeding occurs, the cohort of patients in which it occurs and a paucity of high-quality prospective data to guide treatment decisions. Whilst a range of endoscopic and radiologic management strategies are now available, ambiguity exists about when to utilize each of these therapies. This study comprehensively reviewed current management considerations and the positioning of available treatment modalities for gastric varices. A literature search was performed using PubMed to identify peer-reviewed articles published until December 2025. Whilst a lack of large, randomized trials limits the ability to provide definitive guidance for the management of gastric varices, individualized patient care and a multidisciplinary approach with close collaboration between hepatologists, interventional endoscopists and radiologists is vital. Prompt endoscopic assessment remains important and allows initial management with either direct endoscopic injection (cyanoacrylate glue or thrombin) or if available, EUS-guided therapy. Further follow up endoscopic or EUS-guided therapies appear to be safe and effective, but definitive management with radiologic procedures such as transjugular intrahepatic portosystemic shunt to address global portal hypertension or retrograde transvenous obliteration procedures are highly successful and should also be considered.
Laminectomy fusion fixation (LF) and single open-door laminoplasty (LP) are common posterior surgeries for central cord syndrome without fracture/dislocation (CCSWOFD), yet a comprehensive comparison is lacking. This study compared outcomes of LF vs. LP for multi-segmental cervical canal stenosis with CCSWOFD. A retrospective analysis was conducted on 112 patients (LF group, n = 59; LP group, n = 53). Clinical and radiological outcomes were assessed. A post-hoc power analysis was performed, and multivariate logistic regression was used to identify factors associated with favorable outcomes, adjusting for key confounders. The LF group demonstrated significantly better final Japanese Orthopaedic Association (JOA) scores, recovery rates (RR), intrinsic hand muscle strength (IHMS), and Brain and Spinal Injury Center (BASIC) scores compared to the LP group (P < 0.05). LF also achieved superior postoperative C2-7 Cobb angles despite reduced range of motion (ROM). The sagittal vertical axis (SVA) decreased significantly in the LF group but increased in the LP group. Notably, LF showed superior IHMS and RR outcomes in K-line (-) patients. Complication rates did not differ significantly between groups. Multivariate analysis identified higher preoperative JOA and IHMS as independent protective factors for favorable recovery, while LF was associated with non-significantly greater odds of good outcomes after adjusting for confounders. Both LF and LP effectively improved neurological function, alleviated pain, enhanced motor ability, and reduced spinal cord edema in CCSWOFD patients with multi-segment stenosis. In this retrospective cohort, laminectomy fusion fixation was associated with superior neurological and radiological outcomes compared to laminoplasty for multi-segment CCSWOFD, particularly for patients with coexisting ossification of the posterior longitudinal ligament and K-line (-).
Mandibular buccal bifurcation cyst (MBBC) is an inflammatory cyst that typically manifests during early childhood and is positioned buccal to the furcation area of the mandibular first molars. Clinically, it manifests as a buccal inclination of the crown without associated symptoms or dental vitality loss. The diagnosis is confirmed through a combination of clinical, radiological, surgical, and histological findings. A case of a 9-year-old boy with MBBC is presented. Molar 4.6 exhibits a buccal inclination of the crown and a palpable, nonpainful hard swelling on the vestibular side of the tooth. Radiographic and cone-beam computed tomography (CBCT) imaging revealed a lack of bone structure. A minimally invasive surgical procedure involving a micro-osteotomy was performed, which enabled the en bloc excision of the cyst. A collagen membrane was used to reconstruct the tissues through complete regeneration, in accordance with the principles of guided tissue regeneration (GTR). After a 1-year follow-up period, complete restoration of the cortical bone and the lesion area is observed on a CBCT, with a completely asymptomatic tooth. A precise diagnosis of MBBC lesions is paramount for effective treatment, and this diagnosis must be made through clinical signs, radiographic imaging, and histology. Furthermore, it is imperative to ensure that surgical interventions are performed in a meticulous manner. A case is presented in which the lesion was treated by generating a bony microwindow to access the cyst and enucleate it in a single piece. Additionally, a collagen membrane was used to achieve complete regeneration of the lesion without interference from the soft tissues. The subsequent year of observation revealed a favorable evolution of the case, with complete regeneration of all lost tissues, including the buccal cortical.
Osteoporotic vertebral compression fractures (OVCFs) cause significant morbidity in aging populations. Hounsfield unit (HU) from CT and the vertebral bone quality (VBQ) from MRI show promise in assessing bone quality and fracture risk. This study aims to directly compare the predictive efficacy of HU and VBQ for OVCFs and develop a nomogram model integrating HU and VBQ. A retrospective study was conducted involving 385 patients (127 with OVCFs, 258 controls) who were hospitalized at our hospitals between September, 2020 and September, 2024. HU and VBQ were derived from picture archiving and communication system (PACS). Other variables included demographic, clinical, and radiological data. Statistical analyses included t-tests, chi-square tests, multivariable logistic regression, the least absolute shrinkage and selection operator method (LASSO) regression, and receiver operating characteristic (ROC) curve analysis. Then, a nomogram model was established. The calibration, discrimination and clinical practicability of the nomogram model were also evaluated. The OVCF group had significantly higher VBQ and lower HU compared to controls. ROC analysis showed higher diagnostic accuracy for HU than VBQ.A nomogram model for predicting the risk of OVCF occurrence in patients has been developed based on three independent predictors, namely BMI, HU and VBQ. The AUC was 0.84 in the training set and 0.87 in the test set. The model has good practicability for clinics according to the decision curve analysis (DCA) and clinical impact curve (CIC). Both HU and VBQ are effective predictors of OVCFs. The nomogram model showed good internal discrimination and calibration in our study. These findings suggest potential utility for opportunistic screening of OVCF risk in patients undergoing routine spinal CT and MRI. However, external validation in prospective and multi-center cohorts is needed before clinical implementation.
Ileo-ileal knotting is an exceptionally rare cause of small bowel obstruction in which two ileal loops twist around each other, resulting in vascular compromise and bowel strangulation. Preoperative diagnosis is difficult because of non-specific clinical and radiological findings, and most cases are diagnosed intraoperatively. Delay in treatment may rapidly progress to bowel ischemia and gangrene. We report the case of a 78-year-old male patient who presented with acute intestinal obstruction. Contrast-enhanced computed tomography suggested closed-loop small bowel obstruction without definitive evidence of intestinal knotting. Emergency exploratory laparotomy revealed ileo-ileal knotting with gangrene involving approximately three feet of terminal ileum. Resection of the gangrenous bowel with double-barrel ileostomy was performed successfully. This case highlights the importance of early surgical exploration in rapidly progressive bowel obstruction and emphasizes intestinal knotting as a rare but important differential diagnosis of strangulated obstruction.
Venous fat emboli are uncommon but important radiological findings in patients with long-bone fractures, and direct visualization on computed tomography (CT) is rarely reported. We report the case of a 34-year-old man with polytrauma, reported to be hemodynamically stable, admitted after a motorcycle road traffic accident. Initial radiography demonstrated a complete, displaced fracture of the proximal third of the left femoral shaft. Whole-body trauma CT revealed a fat-attenuation intravascular lesion within the distal left external iliac vein extending into the proximal left common femoral vein, with an attenuation value of approximately -81 Hounsfield units, consistent with a venous fat embolus. The lesion persisted in the same venous location across the available non-contrast, arterial-phase, and portal venous-phase images. Thoracic CT angiography showed no pulmonary arterial filling defect or acute pulmonary parenchymal abnormality on the available images. Abdominopelvic CT also demonstrated a superior polar splenic laceration measuring more than 3 cm in depth, associated with perisplenic hemoperitoneum, consistent with grade III splenic injury according to the American Association for the Surgery of Trauma classification. No definite active contrast extravasation was identified on the available arterial, portal venous, and delayed-phase images. Orthopedic fixation of the femoral fracture was subsequently performed; however, detailed follow-up data, including respiratory evolution, neurological status, laboratory data, splenic injury management, and discharge outcome, were not documented in the available medical record. This case highlights the importance of systematic venous assessment on whole-body trauma CT in patients with long-bone fractures and emphasizes the distinction between a CT-visible venous fat embolus and fat embolism syndrome, which remains a clinical diagnosis requiring appropriate clinical correlation.
An 80-year-old woman from rural Guangxi with post-tuberculosis lung disease (PTLD) (hereinafter referred to as PTLD)presented with one month of cough and fever. One month prior, she had ingested raw rodent meat-a known exposure for Talaromyces marneffei. Chest HRCT showed bilateral tree-in-bud opacities superimposed on prior left lung destruction. Conventional microbiological tests, including acid-fast bacilli smears, were negative. A nasopharyngeal swab was positive for SARS-CoV-2 (cycle threshold 17). Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid identified both T. marneffei and SARS-CoV-2. Her CD4+ count was 344/μL and HIV serology was negative. She received nirmatrelvir-ritonavir and sequential amphotericin B followed by voriconazole, with clinical and radiological improvement. This case illustrates that PTLD may serve as a local anatomical risk factor for talaromycosis even without systemic immunodeficiency.
Intestinal tuberculosis (ITB) most commonly involves the ileocecal region. Isolated sigmoid colonic tuberculosis complicated by a colovesical fistula is extremely rare and may closely mimic colorectal malignancy or Crohn's disease (CD). A 73-year-old man presented with subacute diarrhea, fever, and lower urinary tract symptoms. Laboratory tests showed markedly elevated inflammatory markers and anemia. Cross-sectional imaging demonstrated segmental thickening of the sigmoid colon, pericolic lymphadenopathy, multiple serous effusions, and findings consistent with a colovesical fistula, including bladder wall disruption and intravesical gas. Colonoscopy revealed a circumferential stenosing lesion with irregular ulceration, raising strong suspicion for colorectal malignancy or CD. Initial histopathology showed only mixed inflammatory cell infiltration without granulomas or malignant cells, and empirical antimicrobial therapy failed to control the fever. Given the positive immunological testing for tuberculosis and persistent clinical suspicion, acid-fast bacilli staining and metagenomic next-generation sequencing (mNGS) were performed on colonic biopsy tissue. Acid-fast bacilli were detected, and mNGS identified Mycobacterium tuberculosis complex, confirming ITB. Standard anti-tuberculosis therapy was initiated, leading to rapid clinical improvement, complete endoscopic mucosal healing, and radiological resolution of the colovesical fistula. This case highlights that ITB can present as an isolated tumor-like sigmoid lesion complicated by fistula formation. When routine histology is nondiagnostic, especially in the absence of granulomas, integration of imaging, immunological testing, special staining, and molecular diagnostics may be crucial for early diagnosis, avoidance of misdiagnosis, and timely targeted treatment.
Retrograde jejunojejunal intussusception is a rare but recognized late complication of Roux-en-Y gastric bypass (RYGB). Clinical presentation is often nonspecific and overlaps with other postoperative complications, making imaging crucial for diagnosis. Contrast-enhanced computed tomography (CT) plays a central role by demonstrating characteristic morphological features, defining the level and direction of obstruction, and assessing bowel viability. We present a case of retrograde jejunojejunal intussusception causing high-grade mechanical small bowel obstruction several years after RYGB, highlighting radiological findings and their impact on surgical management.
C5 palsy is a disabling complication after posterior cervical decompression and fusion (PCDF). Whether C4/5 facetectomy reduces the incidence or improves the outcomes of C5 palsy remains uncertain. Therefore, this study aimed to (1) test the association of C4/5 facetectomy with the incidence and recovery of C5 palsy and (2) identify radiological risk factors for C5 palsy. A single-center retrospective cohort study was conducted between April 2013 and January 2024. Adults with degenerative cervical myelopathy, including ossification of the posterior longitudinal ligament, who underwent PCDF that included C4/5 were included. Deltoid manual muscle testing (MMT) was assessed preoperatively at discharge and at the final follow-up. Axial CT was used to measure the bilateral C4/5 foraminal diameter (FD). MRI was used to evaluate posterior cord shift at C4/5 and intramedullary T2 high-signal intensity (T2HI) at C3/4 and C4/5. C5 palsy was defined as a decrease from MMT grade ≥3 to ≤2; recovery was defined as improvement to MMT grade ≥3 at the final follow-up. A prespecified severe stenosis subgroup was defined as FD<2.6 mm. Group comparisons included Fisher's exact test and unpaired t tests; multivariable logistic regression was used to identify risk factors. Ninety-four patients were included; C5 palsy occurred in 20 (21.3%) patients. Facetectomy was not associated with C5 palsy incidence. T2HI at C3/4 was independently associated with C5 palsy (OR: 3.11, 95% CI: 1.05-9.74; p=0.04). In the severe stenosis subgroup, facetectomy did not reduce the incidence of C5 palsy but was associated with improved recovery from C5 palsy (100% (7/7) vs. 25% (1/4); p=0.02). In patients who underwent PCDF including C4/5, C4/5 facetectomy was not associated with a lower occurrence of postoperative C5 palsy. However, in patients with severe preoperative foraminal stenosis, facetectomy was associated with improved recovery after C5 palsy occurred. T2HI at C3/4 was independently associated with C5 palsy development. These findings do not support routine facetectomy for prophylaxis. The observed association between facetectomy and improved recovery in selected patients with marked foraminal stenosis should be interpreted as exploratory, given the retrospective design and small subgroup size.
Pulmonary mucormycosis is a rare but rapidly progressive fungal infection commonly associated with diabetes mellitus, hematologic malignancies, and solid-organ transplants. Prompt diagnosis is essential given the infection's invasive nature and the likelihood of dissemination. The standard treatment typically involves surgical resection and systemic antifungal therapy, specifically liposomal amphotericin B, along with correction of the underlying risk factors. We present a 53-year-old male with diabetes, hypertension, end-stage renal disease (ESRD) on maintenance hemodialysis (MHD) and chronic graft rejection following renal transplantation who presented with progressive respiratory symptoms. Initially treated as community-acquired pneumonia, his clinical condition progressively worsened despite appropriate antimicrobial therapy. Subsequent fibre-optic bronchoscopy (FOB) revealed a friable endobronchial mass with a spongiform appearance completely occluding the left mainstem bronchus and extending into the segmental bronchi, including upper, middle, and lower lobes. Complete resection of the endobronchial lesion was achieved using bronchoscopy-guided techniques, including cryoablation, argon plasma coagulation, and snare-forceps excision, thereby avoiding high-risk surgical intervention. Histopathological examination was consistent with invasive pulmonary mucormycosis. Following bronchoscopy, treatment with liposomal amphotericin B and oral posaconazole for parenchymal disease resulted in significant clinical and radiological improvement. This case highlights the promising role of advanced bronchoscopy-guided interventions as an adjunct to both diagnostic and therapeutic modalities in high-risk cases of pulmonary mucormycosis with an endobronchial component, particularly when conventional surgical approaches are not feasible due to life-threatening post-surgical complications and comorbidities.
Klebsiella pneumoniae invasive liver abscess syndrome (ILAS) is an emerging disease characterized by liver abscess without biliary disease, often with multiorgan metastatic infection. It can cause severe critical illness with significant morbidity and disability. There remains limited literature and understanding of this syndrome in the United States. This article aims to describe the clinical characteristics of hospitalized and critically ill patients with ILAS and providing management considerations for critical care clinicians. Adult patients admitted to Scripps Health from Janurary 1, 2018 to April 1, 2024 were reviewed. Inclusion criteria required radiographic evidence of a liver abscess and cultures (blood or abscess) positive for K. pneumoniae. Data collected included demographics, symptoms and signs, laboratory and radiologic data, metastatic infection characteristics, treatment, mortality, and morbidity. Patient cases were described, and a narrative review describing clinical, therapeutic, and prognostic characteristics was conducted. Six patients had ILAS. Mean age was 54.8 years, no immunosuppression (defined as underlying malignancy, drug-induced, or chronic infection), 83% had diabetes, 50% were male, and 50% were of Asian ethnicity. Liver abscesses were multilocular (50%), and all had percutaneous catheter drainage. Fifty percent of patients developed distant metastatic infections: emphysematous cystitis, pulmonary septic emboli, complicated parapneumonic pleural effusions, meningitis, ventriculitis, cerebral septic emboli, and endophthalmitis. These patients were younger, male, and had a higher rate of intensive care unit (ICU) admission and mechanical ventilation. Two patients required ICU admission with septic shock, diabetic ketoacidosis, respiratory failure, severe thrombocytopenia, and altered mental status. K. pneumoniae isolates were pansensitive except to ampicillin. There was no in-hospital mortality. The patient with meningitis and ventriculitis had full neurological recovery, and the patient with endophthalmitis had very poor residual visual acuity. ILAS is an emerging disease that can cause severe critical illness with multiorgan involvement. Early identification of the disease and metastatic infection is essential to provide appropriate treatment. Additionally, ILAS patients require screening for endophthalmitis.
Angiomatous epulis, also known as vascular epulis or gingival pyogenic granuloma, is a benign reactive gingival lesion characterized by marked capillary proliferation. It typically develops in response to chronic local irritation, trauma, inflammatory stimuli, or hormonal influences. Clinically, it presents as a rapidly growing erythematous to violaceous gingival mass with a marked tendency to bleed, which may mimic malignant gingival tumors and raise diagnostic concern. Although the diagnosis is primarily based on clinicopathological correlation, imaging plays an important complementary role. Radiological evaluation, particularly computed tomography (CT), is useful to assess lesion extent, confirm its superficial localization, and exclude aggressive features such as bone erosion or deep tissue invasion. Imaging also contributes to the differential diagnosis by helping distinguish angiomatous epulis from other gingival lesions, including peripheral giant cell granuloma, peripheral ossifying fibroma, vascular malformations, and malignant tumors. We report the case of a 15-year-old patient presenting with a rapidly progressive gingival mass evolving over two months. Periapical radiography demonstrated preserved alveolar bone architecture, while CT imaging confirmed a well-circumscribed soft-tissue lesion confined to the gingiva, without cortical bone destruction, periodontal ligament alteration, or extension to adjacent structures. Given the rapid growth and bleeding tendency, imaging was essential to exclude malignancy and guide management. Complete surgical excision was performed, and histopathological examination confirmed the diagnosis of angiomatous epulis. This case highlights the added value of imaging in the diagnostic workup of vascular gingival lesions, particularly in differentiating benign entities from malignant conditions and in supporting appropriate therapeutic decision-making.
This study explores the clinical efficacy of ultrasound-assisted minimally invasive treatment for Jakob Type II humeral lateral condyle fractures in children. A retrospective analysis was conducted on children with Jakob Type II humeral lateral condyle fractures who received treatment at our hospital between January 2021 and December 2024. Based on the surgical procedure, the patients were divided into two groups: the Ultrasound combined with x-ray arthrography-guided closed reduction and percutaneous pin fixation group (UA-CRPP) and the Open reduction percutaneous pin fixation group (ORPP). The UA-CRPP group underwent ultrasound-assisted closed reduction and internal fixation for Jakob Type II humeral lateral condyle fractures, with arthrography to assess the articular cartilage surface. The ORPP group underwent open reduction and Kirschner wire fixation for Jakob Type II humeral lateral condyle fractures. Demographic data, surgical time, clinical outcomes, complications, and radiographic data were recorded. A total of 57 patients were included in both groups, with 37 males and 20 females. There were no significant differences between the two groups in terms of gender, age, weight, time from injury to surgery, follow-up time, injury side, or complications such as pin tract infection, deep infection, or intraoperative blood loss(P > 0.05). No cases of nonunion, refracture, or nerve injury were observed in either group. The surgical time and hospital stay were shorter in the UA-CRPP group compared to the ORPP group (P < 0.05), and the radiological union time of fracture was shorter in the UA-CRPP group (P < 0.05). Ultrasound-assisted closed reduction and internal fixation is a feasible and effective treatment option for children with Jakob Type II humeral lateral condyle fractures. Compared with ORPP, it has similar functional effects, but its advantages lie in less invasive, shorter surgical time, and lower complication rate.
Erector spinae plane catheters are increasingly used for rib fracture analgesia, but the influence of catheter insertion technique on catheter position and analgesic effectiveness remains uncertain. In this case series, we describe 11 erector spinae plane catheters inserted using a catheter-through-needle technique for analgesia in patients with rib fractures who underwent chest computed tomography after catheter insertion. Catheter tip position outside the intended fascial plane was identified in six of 11 (55%) catheters. Previous studies of catheter-over-needle systems have reported displacement rates of up to 89%, but cross-study comparisons are limited by small sample sizes and differences in population, catheter techniques and imaging protocols. Interpretation of clinical impact is limited. Pain score recording and analgesic prescribing were not standardised, and patients frequently had multiple injuries requiring multimodal analgesia, making it difficult to isolate the contribution of erector spinae planes catheter position to pain relief. Furthermore, computed tomography demonstrates catheter location but may not reflect local anaesthetic spread or functional block efficacy. These findings highlight clinically relevant uncertainty regarding the relationship between catheter insertion technique, catheter position and patient-centred analgesic effectiveness. Further prospective studies are needed to determine whether insertion techniques affect catheter position, injectate spread and patient-centred analgesic outcomes.
[This corrects the article DOI: 10.3389/fphar.2026.1786648.].
Osteoporosis (OP) is a chronic systemic skeletal disorder that predominantly affects the elderly. It is characterized by an imbalance in bone homeostasis, reduced bone mass, microarchitectural deterioration of bone tissue, and increased bone fragility, ultimately leading to a higher risk of fractures and related complications. With the progression of global population aging, the prevalence of OP continues to rise, underscoring the importance of early diagnosis and timely intervention. However, the diagnosis and management of OP-particularly its early detection-remain limited by material constraints such as diagnostic equipment and by subjective factors including clinician experience, which hinder widespread screening. In recent years, artificial intelligence (AI) has emerged as a transformative technology with advantages of efficiency, objectivity, and scalability, and has been increasingly integrated into various medical domains. For example, AI-assisted musculoskeletal measurements on leg and foot radiographs can reduce the measurement time from 166 seconds to 40 seconds, resulting in an overall efficiency improvement of approximately 70%. Applying AI to the diagnosis and treatment of OP can reduce human error, save labor costs, and improve diagnostic accuracy and clinical efficiency. Numerous studies have investigated AI-based approaches in OP-related research and clinical practice. Despite these promising developments, several important limitations should be acknowledged. Considerable heterogeneity exists among published studies regarding patient populations, AI algorithms, and evaluation metrics. Besides, consistent external validation remains insufficient in many studies. Challenges related to data imbalance and potential selection bias further highlight the need for standardized reporting frameworks and multicenter collaborative research to promote safe clinical adoption of AI technologies in osteoporosis management. This review summarizes current AI applications in OP diagnosis, risk prediction and therapy. We highlight key methodological limitations and emerging trends, aiming to guide future research and facilitate safe clinical implementation of AI in OP management.