FRAX
Also called: FRAX score, fracture risk assessment tool
What it means
FRAX is a free online tool that calculates your 10-year probability of having a major osteoporotic fracture or hip fracture, based on your personal risk factors.
Knowing your actual fracture risk, not just your T-score, helps you and your doctor decide whether further testing or treatment conversations are worth having.
FRAX looks at the bigger picture instead of just one number. It combines your age, sex, weight, height, prior fractures, whether a parent broke a hip, smoking, glucocorticoid use, rheumatoid arthritis, and alcohol intake, plus an optional femoral neck bone density value, to estimate your 10-year chance of a major osteoporotic fracture or hip fracture.
This matters because a T-score alone can be misleading. An older person with osteopenia and a past fracture can actually have a higher real-world risk than a younger person with a lower, more worrying-looking T-score. FRAX is free and widely used by guidelines to help decide whether treatment discussions are warranted.
It's worth asking for your FRAX result alongside any bone scan you have. That said, FRAX has gaps: it doesn't factor in your fall risk, how many prior fractures you've had, or your Trabecular Bone Score. Think of it as a starting point for a conversation with your doctor, not the complete answer.
How sure is this?
Graded Strong Clinical Evidence: Supported by multiple well-designed clinical studies in humans. Read each study with its grade in mind. One study is a piece of the picture, not the whole of it.
Where the Academy teaches it
This page is the short version. The lessons teach it in full, with the context around it and a quiz to lock it in.
Questions people ask about this
A T-score compares your bone density to that of a healthy young adult, measured in standard deviations: -1.0 and above is normal, -1.0 to -2.5 is osteopenia, and -2.5 or below is osteoporosis. But it's just one snapshot of density — it doesn't capture bone quality, your fall risk, or your overall fracture probability, so it's worth tracking several other things alongside it and discussing them with your physician.
Read the full answer →Osteopenia and osteoporosis are both based on your DEXA T-score, just at different points on the same scale. A T-score between -1.0 and -2.5 is called osteopenia (lower-than-average bone mineral density), while -2.5 or below is called osteoporosis (more significant bone loss). They're not two different diseases — they're a continuum, and the cut-off points are statistical conventions used for research and reimbursement, not a biological cliff where something suddenly changes in your skeleton.
Read the full answer →No. A higher bone density score lowers your statistical risk on average, but it doesn't guarantee you won't fracture. Density is only part of what makes bone strong — architecture, bone quality, and your risk of falling all matter too, and many fragility fractures actually happen in people whose scans look normal or only mildly low (osteopenic).
Read the full answer →Related words
A T-score shows how your bone density compares to a healthy young adult, measured in standard deviations, and it's…
A Z-score compares your bone density to other people your own age and sex, which matters most for younger adults,…
A DEXA scan is a low-radiation X-ray test that measures how much mineral is in your hip and spine bones, giving you…
Trabecular Bone Score (TBS) is a measurement taken from your spine DEXA image that estimates how well-connected your…
Fall risk is how likely you are to fall, and it matters because falling—not just weak bones—is the most common cause…
A fragility fracture is a broken bone caused by a fall or bump that normally wouldn't break a healthy bone, often at…
Education only, not medical advice. Decisions about tests, medications and treatment belong with your own doctor. OsteoStrong does not diagnose, treat or cure any disease.
