Bone strength primarily reflects a combination of bone quality and BMD1
After menopause, cortical porosity and trabecular bone loss reduce bone strength and increase risk for low-trauma fracture2
A study suggested that bone microstructure predicted low-trauma fractures in postmenopausal women who would not have qualified as high risk for fracture according to DXA or FRAX scores4‡
Learn more about the risk of subsequent fractures following a fracture
Representative 3D reconstructions of HR-pQCT images of distal radius from a woman with a previous wrist fracture (right) and her age-matched control withoutfracture (left). Their aBMD values were, respectively, 0.309 g/cm2 and 0.316 g/cm2 at the ultradistal radius.3
A matched case-control 13-year follow-up study of 101 women from the OFELY cohort who sustained a fragility fracture and had measures of density andarchitecture at the distal radius and tibia.3
A prospective cohort study of 740 postmenopausal women from the Geneva Retirees Cohort evaluated whether bone microstructure and strength assessmentimprove fracture prediction beyond central aBMD, TBS, and FRAX.4
DXA=dual-energy X-ray absorptiometry; FRAX=fracture risk assessment tool; aBMD=areal BMD; TBS=trabecular bone score.
References: 1. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285(6):785-795. 2. Seeman E. Age- and menopause-related bone loss compromise cortical and trabecular microstructure. J Gerontol A Biol Sci Med Sci. 2013;68(10):1218-1225. 3. Sornay-Rendu E, Boutroy S, Munoz F, Delmas PD. Alterations of cortical and trabecular architecture are associated with fractures in postmenopausal women, partially independent of decreased BMD measured by DXA: the OFELY study. J Bone Miner Res. 2007;22(3):425-433. 4. Biver E, Durosier-Izart C, Chevalley T, van Rietbergen B, Rizzoli R, Ferrari S. Evaluation of radius microstructure and areal bone mineral density improves fracture prediction in postmenopausal women [published online ahead of print September 28, 2017]. J Bone Miner Res. doi:10.1002/jbmr.3299.