Advantages of Radiofrequency Echographic Multi Spectrometry (REMS) in evaluating osteoporosis in the rural area of Sannio: A clinical and economic analysis of a free screening program

Osteoporosis (OP) is a major public health issue in countries with high life expectancy such as Italy, particularly affecting rural populations with limited access to diagnostic and specialist services. This study aimed to investigate OP risk factors, disease awareness, and healthcare experiences in an Italian rural community, and to evaluate the clinical and economic impact of Radiofrequency Echographic Multi Spectrometry (REMS) as a radiation-free diagnostic tool. A free, touring OP screening program was conducted in the rural area of Sannio, southern Italy. Participants underwent semi-structured interviews, fracture risk assessment using the FRAX tool, REMS-based bone evaluation, and biochemical analyses to assess calcium–phosphate metabolism and secondary causes of OP. A total of 347 participants were enrolled in the screening program. Osteoporosis was diagnosed in 37.8% of subjects, while 54% were classified as having osteopenia. Participants reported high satisfaction with the screening initiative. Economic analysis demonstrated that REMS was associated with significant cost savings compared with DXA, with an average reduction of €35.7 per patient, while maintaining diagnostic reliability in both female and male populations. REMS represents a feasible, accurate, and cost-effective diagnostic technology for early osteoporosis detection in rural healthcare settings. Its implementation within the Italian National Health Service (NHS) may improve access to osteoporosis care, reduce health disparities, and support early prevention strategies in underserved populations.