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World J Methodol. Sep 20, 2026; 16(3): 117490
Published online Sep 20, 2026. doi: 10.5662/wjm.v16.i3.117490
Published online Sep 20, 2026. doi: 10.5662/wjm.v16.i3.117490
Fragility fracture risk prediction using quantitative magnetic resonance and Vertebral Bone Quality scoring beyond density
Sanjith Manian, Department of Orthopaedics, Madras Medical College, Chennai 600003, Tamil Nadu, India
Arunagiri Gunasekar, Department of Orthopaedics, Government Medical College and Hospital, Thiruvallur 602001, Tamil Nadu, India
Naveen Jeyaraman, Madhan Jeyaraman, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India
Naveen Jeyaraman, Arulkumar Nallakumarasamy, Madhan Jeyaraman, Department of Rege
Naveen Jeyaraman, Sathish Muthu, Madhan Jeyaraman, Department of Orthopaedics, Orthopaedic Research Group, Coimbatore 641045, Tamil Nadu, India
Arulkumar Nallakumarasamy, Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research, Karaikal 609602, Puducherry, India
Sathish Muthu, Central Research Laboratory, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Kanchipuram 631552, Tamil Nadu, India
Author contributions: Manian S, Gunasekar A, Jeyaraman N, and Nallakumarasamy A analyzed the articles for performing review and wrote the manuscript; Jeyaraman N and Jeyaraman M designed the research; Muthu S and Jeyaraman M finalized the manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Madhan Jeyaraman, MD, PhD, Researcher, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Velappan
Received: December 9, 2025
Revised: January 21, 2026
Accepted: March 5, 2026
Published online: September 20, 2026
Processing time: 214 Days and 3.5 Hours
Revised: January 21, 2026
Accepted: March 5, 2026
Published online: September 20, 2026
Processing time: 214 Days and 3.5 Hours
Core Tip
Core Tip: Fragility fractures remain a global health challenge, with many occurring in patients without dual-energy X-ray absorptiometry-defined osteoporosis. Advanced imaging biomarkers such as quantitative magnetic resonance imaging (T1ρ, T2 mapping, proton density fat fraction, diffusion-weighted imaging) and Vertebral Bone Quality/modified Vertebral Bone Quality scoring provide deeper insights into bone microarchitecture and marrow composition. These tools enhance fracture risk prediction beyond bone mineral density, enabling radiation-free, opportunistic screening and artificial intelligence-driven models that bridge bone quantity and quality for improved prevention and management.