How do FRAX results interact with BMD in determining treatment?

• A. FRAX provides 10-year fracture probabilities; BMD refines risk estimates; treatment is recommended for high FRAX probabilities or when osteoporosis is present by BMD.
• B. FRAX replaces BMD.
• C. FRAX cannot be used with BMD.
• D. BMD alone is enough; FRAX optional.

Answer: (B)

FRAX and BMD work together to tell you how likely a person is to fracture and whether treatment is warranted. FRAX estimates the 10-year probability of a fracture using clinical risk factors, and when you include the femoral neck BMD, that risk estimate becomes more precise because it adds a direct measure of bone density. BMD also provides a clear diagnostic cutoff: a T-score of -2.5 or lower defines osteoporosis, which strongly supports starting treatment. In practice, treatment decisions come from either a high FRAX probability or the presence of osteoporosis by BMD; people with osteopenia may still qualify for treatment if their FRAX risk is elevated. FRAX can be used with or without BMD, but it does not replace BMD—the two together give the most complete picture of fracture risk and treatment need.