Practice Cases
Fracture Risk Assessment: Question Three
Your answer is incorrect. The correct answer is C.
With further questioning, you find out the following about your patient:
- Weight 150 pounds (height 65 inches)
- Alcohol: 3 glasses of wine each night
- No corticosteroid usage (past or present)
- No personal history of a fracture
- Smoking: 1 PPD
- No family history of a hip fracture
You decide to use the FRAX tool to determine her fracture risk given her many risk factors. You have a question about the FRAX tool as you are putting in the data.
Can the total hip BMD rather than the femoral neck BMD be used in the FRAX tool?
- Option A No, you must use total hip BMD
- Option B Yes, these are interchangeable
- Option C Yes, but these are only interchangeable for women and not for men
- Option D No, it is best to leave it blank
Can the total hip BMD rather than the femoral neck BMD be used in the FRAX algorithm?
The FRAX model is constructed from population-based cohorts using femoral neck BMD. However, the total hip BMD can be used interchangeably with femoral neck BMD in women, but not in men (1).
- Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, Eisman JA, Fujiwara S, Kroger H, Mellstrom D, Meunier PJ, Melton LJ III, O'Neill T, Pols H, Reeve J, Silman A, Tenenhouse A. Predictive value of BMD for hip and other fractures. Journal of Bone and Mineral Research 2005; 20: 1185-1194.