Comparison of FRAX score to bone mineral density for estimating fracture risk in patients with CRPC on androgen-deprivation therapy (ADT).

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 101-101
Author(s):  
Marc Nicolas Bienz ◽  
Herbert James ◽  
Ilija Aleksic ◽  
Christopher Michael Pieczonka ◽  
David Albala ◽  
...  
Keyword(s):  
Fracture Risk ◽  
Assessment Tool ◽  
Significant Risk ◽  
Mineral Density ◽  
X Ray ◽  
T Score ◽  
Fracture Risk Assessment Tool ◽  
Frax Score ◽  
Treatment Table ◽  
Country Specific

101 Background: A FRAX algorithm has been elaborated to estimate the ten-year hip fracture risk associated with this under-diagnosed condition. We aim to evaluate the fracture risk of patients who would otherwise be left untreated by the conventional T-score. Methods: Clinical data from 613 PCa patients undergoing ADT was collected from our AMP large urology group. Fracture risk was assessed using the country specific (USA) Fracture Risk Assessment Tool (FRAX). Also, a subset of patients (n=94) had received Dual-energy X-ray Absorptiometry (DXA). We compared the proportion of patients suitable for treatment according to the threshold of the FRAX fracture risk calculated with the BMD (>3%) and the T-score (<-2.5). Results: According to the FRAX algorithm (without BMD), 61.6% of our cohort require treatment. The FRAX score (with BMD) identified 46.8% of patients who had DXA suitable for treatment, in contrast to 19.1% by the T-score alone. Correlations were calculated between the various methods (Table). Conclusions: Our results demonstrate that many patients unidentified for treatment by the conventional T-score are at significant risk for fracture according to the FRAX algorithm with BMD. When calculated without the BMD, an even greater proportion of patients is found to be at risk and suitable for treatment. [Table: see text]

scholarly journals The fracture risk assessment tool (FRAX® score) in subclinical hyperthyroidism

2015 ◽  
Vol 72 (6) ◽  
pp. 510-516 ◽  
Author(s):  
Snezana Polovina ◽  
Dragan Micic ◽  
Dragana Miljic ◽  
Natasa Milic ◽  
Dusan Micic ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Fracture Risk ◽  
Bone Fracture ◽  
Assessment Tool ◽  
Subclinical Hyperthyroidism ◽  
Mineral Density ◽  
Menopausal Women ◽  
Fracture Risk Assessment Tool ◽  
Post Menopausal ◽  
Frax Score

Background/Aim. The Fracture Risk Assessment Tool (FRAX? score) is the 10-year estimated risk calculation tool for bone fracture that includes clinical data and hip bone mineral density measured by dual-energy x-ray absorptiometry (DXA). The aim of this cross-sectional study was to elucidate the ability of the FRAX? score in discriminating between bone fracture positive and negative pre- and post-menopausal women with subclinical hyperthyroidism. Methods. The bone mineral density (by DXA), thyroid stimulating hormone (TSH) level, free thyroxine (fT4) level, thyroid peroxidase antibodies (TPOAb) titre, osteocalcin and beta-cross-laps were measured in 27 pre- and post-menopausal women with newly discovered subclinical hyperthyroidism [age 58.85 ? 7.83 years, body mass index (BMI) 27.89 ? 3.46 kg/m2, menopause onset in 46.88 ? 10.21 years] and 51 matched euthyroid controls (age 59.69 ? 5.72 years, BMI 27.68 ? 4.66 kg/m2, menopause onset in 48.53 ? 4.58 years). The etiology of subclinical hyperthyroisims was autoimmune thyroid disease or toxic goiter. FRAX? score calculation was performed in both groups. Results. In the group with subclinical hyperthyroidism the main FRAX? score was significantly higher than in the controls (6.50 ? 1.58 vs 4.35 ? 1.56 respectively; p = 0.015). The FRAX? score for hip was also higher in the evaluated group than in the controls (1.33 ? 3.92 vs 0.50 ? 0.46 respectively; p = 0.022). There was no correlations between low TSH and fracture risk (p > 0.05). The ability of the FRAX? score in discriminating between bone fracture positive and negative pre- and postmenopausal female subjects (p < 0.001) is presented by the area under the curve (AUC) plotted via ROC analysis. The determined FRAX score cut-off value by this analysis was 6%, with estimated sensitivity and specificity of 95% and 75.9%, respectively. Conclusion. Pre- and postmenopausal women with subclinical hyperthyroidism have higher FRAX? scores and thus greater risk for low-trauma hip fracture than euthyroid premenopausal women. Our results point to the use of FRAX? calculator in monitoring pre- and postmenopausal women with subclinical hyperthyroidism to detect subjects with high fracture risk in order to prevent further fractures.

Radiology of Osteoporosis

2016 ◽  
Vol 67 (1) ◽  
pp. 28-40 ◽  
Author(s):  
Thomas M. Link
Keyword(s):  
Computed Tomography ◽  
Fracture Risk ◽  
New Technologies ◽  
Assessment Tool ◽  
Quantitative Computed Tomography ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Bone Architecture ◽  
Mineral Density ◽  
Fracture Risk Assessment Tool

The radiologist has a number of roles not only in diagnosing but also in treating osteoporosis. Radiologists diagnose fragility fractures with all imaging modalities, which includes magnetic resonance imaging (MRI) demonstrating radiologically occult insufficiency fractures, but also lateral chest radiographs showing asymptomatic vertebral fractures. In particular MRI fragility fractures may have a nonspecific appearance and the radiologists needs to be familiar with the typical locations and findings, to differentiate these fractures from neoplastic lesions. It should be noted that radiologists do not simply need to diagnose fractures related to osteoporosis but also to diagnose those fractures which are complications of osteoporosis related pharmacotherapy. In addition to using standard radiological techniques radiologists also use dual-energy x-ray absorptiometry (DXA) and quantitative computed tomography (QCT) to quantitatively assess bone mineral density for diagnosing osteoporosis or osteopenia as well as to monitor therapy. DXA measurements of the femoral neck are also used to calculate osteoporotic fracture risk based on the Fracture Risk Assessment Tool (FRAX) score, which is universally available. Some of the new technologies such as high-resolution peripheral computed tomography (HR-pQCT) and MR spectroscopy allow assessment of bone architecture and bone marrow composition to characterize fracture risk. Finally radiologists are also involved in the therapy of osteoporotic fractures by using vertebroplasty, kyphoplasty, and sacroplasty. This review article will focus on standard techniques and new concepts in diagnosing and managing osteoporosis.

scholarly journals Instrumental diagnosis of osteosarcopenia in diagrams and tables

2021 ◽  
pp. 358-364
Author(s):  
A. V. Naumov ◽  
D. V. Demenok ◽  
Yu. S. Onuchina ◽  
N. O. Khovasova ◽  
V. I. Moroz ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Physical Performance ◽  
Assessment Tool ◽  
Mass Function ◽  
Dual Energy ◽  
Whole Body ◽  
Mineral Density ◽  
X Ray ◽  
Fracture Risk Assessment Tool ◽  
History Of

Osteoporosis and sarcopenia are age-associated diseases of the musculoskeletal system. Osteosarcopenia, the presence of osteopenia/osteoporosis and sarcopenia. The prevalence of osteosarcopenia in older adults with failing was 37% and associated with higher rate of death. Diagnosis of osteosarcopenia consists of describing medical history of fractures, providing x-ray of the spine (if it is needed) and bone densitometry, calculation of Fracture Risk Assessment Tool (FRAX), evaluating muscle strength, mass, function. The most common exam which is used to measure bone mineral density (BMD) is dual-energy x-ray absorptiometry (DXA or DEXA). Screening using the FRAX is recommended in all postmenopausal women and mеn over 50 in order to identify individuals with high probability of fractures. It is recommended to diagnose osteoporosis in patients with fragility fracture of large bones of the skeleton. Diagnosis of sarcopenia is consist of measures for three parameters: muscle strength, muscle quantity/quality and physical performance as an indicator of severity. Muscle strength can be measured with carpal dynamometry. Muscle mass can be evaluated dual-energy X-ray absorptiometry (program «Whole body»). Muscle function can be evaluated with short physical performance battery (SPPB) tests. In this article described algorithm of diagnosis of osteosarcopenia.

scholarly journals Simple Self-Assessment Tool to Predict Osteoporosis in Taiwanese Men

2021 ◽  
Vol 8 ◽  
Author(s):  
Dung-Huan Liu ◽  
Chung-Yuan Hsu ◽  
Pei-Ching Wu ◽  
Ying-Chou Chen ◽  
You-Yin Chen ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Risk Index ◽  
Area Under The Curve ◽  
Assessment Tools ◽  
Mineral Density ◽  
Self Assessment ◽  
Fracture Risk Assessment Tool ◽  
Patients At Risk ◽  
Taiwanese Men ◽  
Country Specific

Background: Although the self-assessment tools for predicting osteoporosis are convenient for clinicians, they are not commonly used among men. We developed the Male Osteoporosis Self-Assessment Tool for Taiwan (MOSTAi) to identify the patients at risk of osteoporosis.Methods: All the participants completed a questionnaire on the clinical risk factors for the fracture risk assessment tool. The risk index was calculated by the multivariate regression model through the item reduction method. The receiver operating characteristic (ROC) curve was used to analyze its sensitivity and specificity, and MOSTAi was developed and validated.Results: A total of 2,290 men participated in the bone mineral density (BMD) survey. We chose a model that considered two variables (age and weight). The area under the curve (AUC) of the model was 0.700. The formula for the MOSTAi index is as follows: 0.3 × (weight in kilograms) – 0.1 × (years). We chose 11 as the appropriate cut-off value for the MOSTAi index to identify the subjects at the risk of osteoporosis.Conclusions: The MOSTAi is a simple, intuitive, and country-specific tool that can predict the risk of osteoporosis in Taiwanese men. Due to different demographic characteristics, each region of the world can develop its own model to identify patients with osteoporosis more effectively.

scholarly journals Comparison of osteoporotic fracture risk in surgical and natural menopausal patients

2021 ◽  
Vol 67 (3) ◽  
pp. 322-327
Author(s):  
Ayça Utkan Karasu ◽  
Yetkin Karasu ◽  
Müzeyyen Gülnur Özakşit ◽  
Yusuf Üstün ◽  
Yaprak Üstün Engin
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Osteoporotic Fracture ◽  
Assessment Tool ◽  
Lumbar Vertebrae ◽  
Mineral Density ◽  
Natural Menopause ◽  
T Score ◽  
Surgical Menopause

Objectives: This study aims to compare the fracture risk calculated with Fracture Risk Assessment Tool (FRAX®) in patients with natural and surgical menopause. Patients and methods: Between April 2019 and July 2019, 285 postmenopausal patients (mean age 57.3 years; range, 40 to 78 years) who were admitted to the menopause clinic were enrolled in this prospective cross-sectional study. Of these, 220 were in natural menopause and 65 were in surgical menopause. Demographic data, medical history, and International Physical Activity Questionnaire scores were collected through face-to-face interviews with the patients. Femoral neck and lumbar vertebrae (L1-L4) T-scores were evaluated using dual-energy X-ray absorptiometry. Fragility fracture risk was assessed using FRAX®. Results: The groups were similar in terms of age, body mass index, duration of menopause, smoking, alcohol use, and history of fracture (p>0.05). The risk of major osteoporotic fracture and hip fracture calculated without adding bone mineral density (BMD) was similar between groups (p=0.417 and p=0.234). The risk of hip fracture calculated with the addition of BMD was higher in natural menopause patients (p=0.023). Lumbar vertebrae T-scores were similar between two groups regardless of age; femoral neck T-scores were higher in surgical menopause (T-score=-0.8) than natural menopause group (T-score=-1.25) aged under 60 years, whereas this difference disappeared after 60 years of age. Conclusion: In our study, the fracture risk and the severity of osteoporosis were not different in surgical menopausal patients compared to the natural menopausal patients. Hip fracture risk calculated using BMD was lower in patients under 50 years of age in surgical menopausal patients. However, the fracture risks were similar in both groups after 50 years of age.

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