What is the FRAX tool and what does it mean?
The FRAX tool is an online calculator used to estimate your chance of sustaining a major osteoporotic bone fracture in the next 10 years. You can do the scoring yourself, online, whether you have had a DEXA scan or not. Some DEXA scan reports are now including the results in the DEXA report. If you want more information about where it came from and how to use it, read on!
The FRAX Tool
Over the past few months, I have been working diligently to review the details of DEXA scans to make them easily understandable. Many of you have asked me what they mean, and I'm trying to help you sort through them.
Before you ask, let me tell you, it is NOT included in all DEXA scan reports. Just like the trabecular bone score (TBS) is in some reports and not others, the FRAX tool is not always a part of your DEXA report.
The good news is, you can easily calculate it yourself. I will show you how later in the email.
What does FRAX stand for?
FRAX stands for Fracture Risk Assessment Tool. It was developed in the UK in 2008. It is used to help predict the 10-year probability that you will sustain a major fracture. The fracture risk includes the hip area, the spine, the forearm, and the shoulder.
The FRAX tool is generally used to help you and your doctor decide if taking osteoporosis medication would help reduce your RISK of fracture. It cannot tell you to take medication; it just helps calculate your risk of sustaining a fracture so you can make an informed decision about your plan going forward.
This is one more piece of information for you to consider when evaluating your options.
If you do not see the FRAX assessment on your DEXA scan, you can do it yourself here.
If you have your most recent DEXA scan information, you can add it to the FRAX tool; you just need your T-score.
The T-score number you need is from your femoral neck. Prepare that for question 12, specifically the drop-down menu where it says 'Select BMD'. BMD (stands for bone mineral density). The good news is you can still do it even if you have not yet had a DEXA scan.
Example of a FRAX report
FRAX Tool Interpretation
In the above example, the risk of a Major Osteoporotic Fracture was calculated to be 11.2%. The Rx threshold is stated to be 20%. This report indicates no need to be considered for medication intervention.
The hip fracture risk was 1.0%, which is significantly lower than the 3% Rx threshold. So, although this person has osteopenia, medication intervention is not likely to be needed.
I hope you found it helpful. Go ahead and see what your DEXA scan says, or calculate your own FRAX score from the online calculator.
Where to get support to reduce your risk of fracture
I go over this and so much more with my Strong Women, Strong Bones members. I start a new group several times a year, get on the waitlist below, and be part of a bone-building family of friends.
Thank you for being here and reading this far.
One more thought before I sign off. 💡The next time you schedule a DEXA scan, please ask if you will get a TBS score and a FRAX score. If not, consider switching your DEXA scan to another facility with up-to-date software!
Keep moving and stay strong.
If you are looking for more information and helpful tips around DEXA scans, bone health, and more, join my newsletter family below, and you’ll receive lots of helpful information directly to your inbox.
Andrea Trombley PT, DPT
REFERENCES
Burnett-Bowie SM, Wright NC, Yu EW, Langsetmo L, Yearwood GMH, Crandall CJ, Leslie WD, Cauley JA. The American Society for Bone and Mineral Research Task Force on clinical algorithms for fracture risk report. J Bone Miner Res. 2024 May 24;39(5):517-530. doi: 10.1093/jbmr/zjae048. PMID: 38590141.
Dickens LT, Jain RK. An Update on the Fracture Risk Assessment Tool: What Have We Learned over 15+ years? Endocrinol Metab Clin North Am. 2024 Dec;53(4):531-545. doi: 10.1016/j.ecl.2024.08.001. Epub 2024 Sep 10. PMID: 39448135.