arXiv:2510.23876v1 Announce Type: new
Abstract: Osteoporosis and osteopenia remain vastly underdiagnosed. Current clinical screening relies almost exclusively on dual-energy X-ray absorptiometry (DXA), which measures bone mineral density (BMD) but fails to capture the compositional changes that lead to BMD loss. We investigated whether Spatially Offset Raman Spectroscopy (SORS) applied to excised finger bones can assess subsurface biochemical markers capable of diagnosing osteoporosis and osteopenia and predicting wrist DXA T-scores. Raman spectra were acquired ex vivo on the mid-shaft of the proximal phalanx of the second digit from 25 female cadavers spanning the three T-score categories (n=8 normal, n=6 osteopenic, and n=11 osteoporotic) at spatial offsets of 0, 3, and 6 mm from a laser irradiation spot. After normalizing spectra to the PO43- peak, group-averaged spectra of the three categories, measured at 3-mm offset, showed clear differences in the CO32-, Amide III, CH2, and Amide I bands. Quantitatively, four out of five mineral-to-matrix ratios differed significantly (p