Which tool is used to estimate 10-year fracture risk and guide therapy decisions in osteoporosis?

• A. FRAX.
• B. DEXA scanning only.
• C. MRI.
• D. X-ray.

Answer: (A)

Estimating how likely a patient is to have a fracture over the next decade is the focal idea. FRAX is the tool that does this by combining clinical risk factors (age, sex, prior fracture, smoking, alcohol use, glucocorticoid therapy, rheumatoid arthritis, secondary osteoporosis, and other factors) with bone density data when available to calculate a 10-year probability of a major osteoporotic fracture and a separate risk of hip fracture. This personalized risk helps determine whether to start osteoporosis treatment and which approach to use, rather than just telling you how dense the bones are.

DEXA scanning measures bone mineral density to classify bone health (normal, osteopenia, osteoporosis) but it does not by itself provide a 10-year fracture risk. MRI and X-ray are imaging tests for structure and current injury; they don’t estimate future fracture probability. So FRAX is the best option for estimating 10-year fracture risk and guiding therapy decisions.