Assessment of fracture risk

Fractures are a common complication of osteoporosis. Although osteoporosis is defined by bone mineral density at the femoral neck, other sites and validated techniques can be used for fracture prediction. Several clinical risk factors contribute to fracture risk independently of BMD. These include age, prior fragility fracture, smoking, excess alcohol, family history of hip fracture, rheumatoid arthritis and the use of oral glucocorticoids. These risk factors in conjunction with BMD can be integrated to provide estimates of fracture probability using the FRAX (R) tool. Fracture probability rather than BMD alone can be used to fashion strategies for the assessment and treatment of osteoporosis. (C) 2009 Elsevier Ireland Ltd. All rights reserved.