Bone health
Comprehensive Osteoporosis Risk Stratifier
Evaluate fracture risk using a point-based score inspired by FRAX® clinical risk factors. This tool supports shared decision-making for DXA testing and pharmacotherapy.
Use latest DXA result. Leave blank if unknown.
Calculated BMI
24.2
Base age/BMI score
9
Risk factors + T-score
6
Total risk score
15
Moderate riskOrder DXA if not done in past 2 years, address reversible risk factors, and consider medication if T-score ≤ −2.5 or FRAX ≥ treatment thresholds.
How to Use This Calculator
Collect core data
Record age, sex, height, weight, and the most recent femoral neck T-score if available.
Assess clinical risk factors
Toggle each FRAX-like factor (prior fracture, glucocorticoids, smoking, etc.) present for the patient.
Use risk tier to guide decisions
Discuss DXA screening, lifestyle changes, and pharmacotherapy in line with national guidelines.
Formula
Total risk score = Base(age + BMI + sex) + Σ(risk factor weights) + T-score adjustment
- Base: sex (female=5, male=3) + age points (50–59 +2, 60–69 +4, 70–79 +6, ≥80 +8) + BMI points (<18.5 +3, 18.5–20.9 +2, 21–22.9 +1)
- Risk factors: prior fracture +3, parental hip fracture +2, smoking +2, glucocorticoids +2, rheumatoid arthritis +2, secondary osteoporosis +2, alcohol ≥3/day +1, low vitamin D +1, low calcium intake +1
- T-score: ≤−2.5 +5, −2.5<T≤−2 +3, −2<T≤−1.5 +2, −1.5<T≤−1 +1
Risk tiers: <8 low, 8–11 mild, 12–17 moderate, ≥18 high (educational guidance).
Full Description
Osteoporosis risk stratification guides DXA screening intervals and therapy decisions. This calculator provides an educational approximation of fracture risk by combining age, body habitus, bone density, and clinical risk factors. Use alongside FRAX®, NOF, or national guidelines for treatment thresholds.
Lifestyle modifications (adequate calcium/vitamin D, smoking cessation, limiting alcohol, fall prevention) benefit all risk groups. High-risk individuals may require bisphosphonates, RANKL inhibitors, or anabolic agents after evaluating contraindications.
Frequently Asked Questions
How does this differ from FRAX®?
This tool provides tiered risk using similar inputs but does not estimate absolute 10-year probability. Use official FRAX® calculators for country-specific probabilities.
Should men be screened?
Yes—men ≥70 or younger men with significant risk factors should undergo DXA. Adjust thresholds per guideline recommendations.
What if T-score is unavailable?
The calculator still functions using clinical risk factors. Obtain DXA to refine risk and track bone density changes.
How often should risk be reassessed?
Every 1–2 years for high-risk patients or after significant health changes (fracture, new medications). Low-risk individuals may be reassessed every 3–5 years.