What FRAX score justifies osteoporosis treatment?

UK NOGG: treat if FRAX hip ≥3% or major fracture ≥20%; USA NBHA: treat if hip ≥3% or major ≥20%; thresholds vary by country; FRAX with BMD provides better discrimination than clinical factors alone.

What clinical risk factors does FRAX include?

Age, sex, body weight, height, prior fracture, parental hip fracture, current smoking, glucocorticoids (prednisolone >5 mg/day ≥3 months), RA, secondary osteoporosis, alcohol ≥3 units/day, and BMD (femoral neck T-score).

Does FRAX account for number of prior fractures?

FRAX does not distinguish 1 versus 3 prior fragility fractures; multiple fractures substantially increase risk beyond FRAX estimates; imminent fracture risk (especially within 2 years of recent fracture) is not well-captured.

What T-score is used in FRAX?

Femoral neck T-score is used in FRAX; total hip T-score is NOT used; if lumbar spine T-score is significantly lower than femoral neck, FRAX may underestimate fracture risk (as in glucocorticoid osteoporosis).

How should FRAX be interpreted with glucocorticoids?

FRAX underestimates fracture risk in glucocorticoid-induced osteoporosis; correction factor: for prednisolone >7.5 mg/day, multiply FRAX hip by 1.15 and major fracture by 1.15; ACR has separate glucocorticoid-specific fracture risk model.

FRAX 10-Year Fracture Probability Calculator

Calculates 10-year probability of major osteoporotic fracture (hip, spine, wrist, humerus) and hip fracture specifically using FRAX clinical risk factors with or without BMD, with country-specific intervention thresholds.

⚕ Clinical Disclaimer: These calculators are for educational and reference purposes only. Always verify results with qualified clinical judgment and current clinical guidelines. Do not use as a sole basis for medical decisions.

How It Works

Each component has a specific meaning:

FRAX clinical risk factors — The frax clinical risk factors recorded for the scenario being assessed.

Note: Interpret the frax score result against the thresholds and context described above.

How to Use

Enter the FRAX clinical risk factors for the scenario you are assessing. Calculates 10-year probability of major osteoporotic fracture (hip, spine, wrist, humerus) and hip fracture specifically using FRAX clinical risk factors with or without BMD, with country-specific intervention thresholds. Use the frax score result to inform your calculation.

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