BOX 3.

Assessment of fracture risk with FRAX without BMD

• Fracture risk should be assessed in postmenopausal women with one or more clinical risk factor where assessment would influence management. • Women with a prior fragility fracture should be considered for treatment without the need for further risk assessment. • In men, and in women without a prior fragility fracture, the 10-year probabilities of a major osteoporotic fracture (clinical spine, hip, forearm or humerus) and hip fracture should be determined using FRAX without BMD. In the absence of other clinical considerations, men and women with probabilities below the intervention threshold can be reassured. • Treatment can be considered in those in whom fracture probabilities lie above the intervention threshold.

*From [3], with kind permission from Springer Science and Business Media