title: The assessment of fracture risk.
abstract: Bone mineral density is considered to be the standard measure for the diagnosis of osteoporosis and the assessment of fracture risk. The majority of fragility fractures occur in patients with bone mineral density in the osteopenic range. The Fracture Risk Assessment Tool (FRAX) can be used as an assessment modality for the prediction of fractures on the basis of clinical risk factors, with or without the use of femoral neck bone mineral density. Treatment of osteoporosis should be considered for patients with low bone mineral density (a T-score of between -1.0 and -2.5) as well as a ten-year risk of hip fracture of > or = 3% or a ten-year risk of a major osteoporosis-related fracture of > or = 20% as assessed with the FRAX. Biochemical bone markers are useful for monitoring the efficacy of antiresorptive or anabolic therapy and may aid in identifying patients who have a high risk of fracture. An approach combining the assessment of bone mineral density, clinical risk factors for fracture with use of the FRAX, and bone turnover markers will improve the prediction of fracture risk and enhance the evaluation of patients with osteoporosis.
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. unnanuntanaa@hss.edu
authors.forename: Aasis
authors.initials: A
authors.lastname: Unnanuntana
authors.forename: Brian P
authors.initials: BP
authors.lastname: Gladnick
authors.forename: Eve
authors.initials: E
authors.lastname: Donnelly
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Lane
mesh_terms: D015502:Absorptiometry, Photon; D015519:Bone Density; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D010024:Osteoporosis / Q000150:complications*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors