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Rheumatology Endocrinology Geriatrics A

FRAX — Fracture Risk Assessment (Simplified)

FRAX estimates the 10-year probability of hip and of major osteoporotic fracture from clinical risk factors, with or without femoral-neck BMD, using country-specific models. This page explains how to use it.

Used in: Osteoporosis

How to use & interpret

FRAX estimates the 10-year probability of a major osteoporotic fracture and of hip fracture from clinical risk factors (age, sex, BMI, previous fracture, parental hip fracture, smoking, glucocorticoids, rheumatoid arthritis, secondary osteoporosis and alcohol), with or without a femoral-neck bone density (BMD) result.

In the UK the output is interpreted against NOGG thresholds to decide on reassurance, BMD measurement, or treatment. FRAX informs but does not dictate the decision, and it has recognised limitations (e.g. it does not capture dose of steroids, number/recency of fractures, or falls risk).

Frequently asked questions

Do I need a bone density scan to use FRAX?

No — FRAX can be calculated without BMD and is often used first to decide who needs a DXA scan; adding the femoral-neck BMD refines the estimate.

References

Related

Curated clinical cross-links plus same-class fallbacks.

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Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.