FRAX, FRAXplus, Osteoporosis and Sarcopenia
DNB Orthopaedics • October 2024 • Paper I • 10 Marks
Introduction
Osteoporosis and sarcopenia are closely related disorders of ageing that together markedly increase the risk of falls, fragility fractures, disability and mortality.
Bone mineral density alone does not completely predict fracture risk. Therefore modern osteoporosis management is based on estimation of absolute fracture probability by tools such as FRAX, followed by risk-stratified preventive and pharmacological treatment.
Core concept
FRAX answers: “What is this patient's probability of
sustaining an osteoporotic fracture in the next 10 years?”
FRAXplus answers: “Does additional clinical information
substantially modify that FRAX probability?”
Definition of Osteoporosis
Osteoporosis is a systemic skeletal disorder characterised by low bone mass and deterioration of bone microarchitecture, resulting in increased bone fragility and susceptibility to fracture.
By DXA criteria in postmenopausal women and older men, a T-score ≤ −2.5 at an accepted skeletal site is diagnostic of osteoporosis.
FRAX — Fracture Risk Assessment Tool
Definition
FRAX is a computer-based fracture-risk assessment algorithm that combines clinical risk factors, with or without femoral-neck BMD, to calculate an individual's 10-year probability of fracture.
Output 1
10-year probability of hip fracture
Output 2
10-year probability of…