FRAX Flashcards
What does FRAX measure?
Estimation of 10 year risk of osteoporotic fracture in untreated patients
(spine, hip, shoulder or wrist)
In those 40–90 years old.
What personal information is included?
Age.
Sex.
Weight (kg).
Height (cm).
What PMH is included?
Rheumatoid arthritis.
Previous fracture.
Secondary osteoporosis;
- Kidney failure,
- Hyperthyroidism,
- Coeliac disease,
- Kidney failure,
- T1DM,
- Cushings
- MS
- Hyperparathyroidism
- Chronic liver disease,
- Premature menopause.
Femoral neck BMD from previous DEXA-T scan (g/cm2).
What DHx, FHx and SHx is included?
Glucocorticoids
Lithium
Barbiturates
Parental fractured hip
Smoker
Alcohol intake (3 or more units/day)
What does a T score show?
How much your bone density is higher/lower than the bone density of a healthy 30-year old adult.
What is a Z score?
Compares the condition of your bones with someone of your age/sex/weight/ethnicity.
What are the different T scores and what do they mean?
T–score ≥ –1 = normal bone density, no intervention.
–2.5 < T–score ≤ –1 = osteopenia, consider medication, lifestyle advice
T–score ≤ –2.5 = osteoporosis, medication, lifestyle advice.
What does low risk mean?
≤10%, reassess 5y
What does intermediate risk mean?
10 < % < 20
What does high risk mean?
≥20%
What advice can be given for a low risk score?
Lifestyle advice;
- More weight-bearing exercise,
- quitting smoking and limiting alcohol.
- Calcium + vitamin D rich diet
- Balance exercises.
Home adaptations;
- Getting rid of throw rugs, installing grab bars.
- Wearing shoes with good grip.
What advice can be given for a intermediate risk score?
DEXA scan to measure BMD
if ≤–2.5,
- Tx with bisphosphonate like alendronate 10mg OD or denosumab (RANK-L), teriparatide.
What advice can be given for a high risk score?
T-score >–2.5 modify risk factors and reassess in 2 years.
T score <–2.5 Tx as in intermediate
What foods are calcium rich?
Yoghurt
Tofu
Leafy greens
Dried fruit
