TY - JOUR T1 - The Assessment of Fracture Risk AU - Unnanuntana, Aasis AU - Gladnick, Brian P. AU - Donnelly, Eve AU - Lane, Joseph M. Y1 - 2010/03/01 N1 - 10.2106/JBJS.I.00919 JO - The Journal of Bone & Joint Surgery SP - 743 EP - 753 VL - 92 IS - 3 N2 - Bone mineral density is considered to be the standard measure for the diagnosis of osteoporosis and the assessment of fracture risk. The majority of fragility fractures occur in patients with bone mineral density in the osteopenic range.The Fracture Risk Assessment Tool (FRAX) can be used as an assessment modality for the prediction of fractures on the basis of clinical risk factors, with or without the use of femoral neck bone mineral density. Treatment of osteoporosis should be considered for patients with low bone mineral density (a T-score of between -1.0 and -2.5) as well as a ten-year risk of hip fracture of =3% or a ten-year risk of a major osteoporosis-related fracture of =20% as assessed with the FRAX.Biochemical bone markers are useful for monitoring the efficacy of antiresorptive or anabolic therapy and may aid in identifying patients who have a high risk of fracture.An approach combining the assessment of bone mineral density, clinical risk factors for fracture with use of the FRAX, and bone turnover markers will improve the prediction of fracture risk and enhance the evaluation of patients with osteoporosis. SN - 0021-9355 M3 - doi: 10.2106/JBJS.I.00919 UR - http://dx.doi.org/10.2106/JBJS.I.00919 ER -