What is the FRAX tool?
Over the past few months, I have been doing my best to go through the details of DEXA scans to help make them more understandable. Many of you have asked me what they mean, and I am trying to help you sort through them!
This week, I want to review the FRAX tool.
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.
But first, what is it?
FRAX stands for Fracture Risk Assessment Tool, which was developed in the UK in 2008. It is used to predict the 10-year probability that you will sustain a fracture. The fracture risk includes the hip area, the spine, the forearm, and the shoulder.
The FRAX tool is often 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.
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 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.
Here is an example of what your FRAX results might look like in your DEXA report:
In this example, the risk of a major osteoporotic fracture was calculated to be 11.2%, well below the 20% threshold needed to be considered for medication intervention.
The hip fracture risk was 1.0%, which is significantly lower than the 3% threshold. So, although this person has osteopenia, medication is not the first line of defense.
I hope you found it helpful.
I go over this and so much more with my Strong Women, Strong Bones members. I start a new group , so get onsevereal times a year, get on the waitlist and stay on top of the details.
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,
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.