Please answer the questions below to calculate the ten year probability of fracture with BMD.
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For USA use only
Consider FDA-approved medical therapies in postmenopausal women and men aged 50 years and older, based on the following:
- A hip or vertebral (clinical or morphometric) fracture
- T-score ≤ -2.5 at the femoral neck or spine after appropriate evaluation to exclude secondary causes
- Low bone mass (T-score between -1.0 and -2.5 at the femoral neck or spine) and a 10-year probability of a hip fracture ≥ 3% or a 10-year probability of a major osteoporosis-related fracture ≥ 20% based on the US-adapted WHO algorithm
- Clinicians judgment and/or patient preferences may indicate treatment for people with 10-year fracture probabilities above or below these levels
For the clinical risk factors a yes or no response is asked for. If the field is left blank, then a "no" response is assumed. See also notes on risk factors.
The risk factors used are the following:
Notes on risk factors
A special situation pertains to a prior history of vertebral fracture. A fracture detected as a radiographic observation alone (a morphometric vertebral fracture) counts as a previous fracture. A prior clinical vertebral fracture or a hip fracture is an especially strong risk factor. The probability of fracture computed may therefore be underestimated. Fracture probability is also underestimated with multiple fractures.
Smoking, alcohol, glucocorticoids
These risk factors appear to have a dose-dependent effect, i.e. the higher the exposure, the greater the risk. This is not taken into account and the computations assume average exposure. Clinical judgment should be used for low or high exposures.
Rheumatoid arthritis (RA)
RA is a risk factor for fracture. However, osteoarthritis is, if anything, protective. For this reason reliance should not be placed on a patient's report of 'arthritis' unless there is clinical or laboratory evidence to support the diagnosis.
Bone mineral density (BMD)
The site and reference technology is DXA at the femoral neck. T-scores are based on the NHANES reference values for women aged 20-29 years. The same absolute values are used in men.