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Osteoporosis Risk Calculator

FRAX-inspired score for 10-year major osteoporotic fracture risk — based on age, sex, BMI, and 8 established clinical risk factors.

Clinical risk factors

If you have a bone density (DXA) result, the T-score refines the estimate.

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FRAX score categories

CategoryPoints10-year risk (estimated)
Low0–3< 10 %
Moderate4–710–20 %
High≥ 8> 20 %

How it works

The calculator combines the main WHO FRAX risk factors into a simple point score: age (0–7 points), female sex (+1), low BMI (+1 to +2), previous fracture (+3), parent hip fracture (+2), smoking (+1), long-term glucocorticoids (+2), rheumatoid arthritis (+1), secondary osteoporosis (+1), and heavy alcohol use (+2). If a DXA result is available, the T-score adjusts the total (+1 for osteopenia, +3 for osteoporosis). A score ≥ 8 corresponds to the NOF/DVO treatment threshold.

This calculator provides a risk estimate — it does not replace an official FRAX report or a DXA bone density scan. Treatment decisions require a clinician's individualized assessment. With sudden back pain or height loss > 4 cm, seek imaging to rule out vertebral fracture.

Frequently Asked Questions

What is osteoporosis?+
Osteoporosis is a systemic skeletal disease with reduced bone mass and disrupted micro-architecture, leading to fragile bones — especially at the spine, hip, wrist, and humerus. Worldwide, about 200 million people are affected, mostly post-menopausal women.
What is FRAX?+
FRAX (Fracture Risk Assessment Tool) is a WHO-developed algorithm that estimates the 10-year probability of major osteoporotic fracture (hip, spine, forearm, shoulder). It uses 11 clinical risk factors and optionally bone density (DXA T-score).
When is treatment required?+
Most guidelines (NOF, DVO) recommend pharmacologic treatment when the 10-year major fracture risk exceeds 20 % — corresponding to a score of ≥ 8 in our calculator. A prior vertebral fracture or T-score ≤ -2.5 typically triggers immediate treatment.
Which medications are used?+
First-line: bisphosphonates (alendronate, risedronate, zoledronate) — effective and inexpensive. Alternatives: denosumab (antibody), teriparatide (PTH analog for severe cases), romosozumab. Always combined with vitamin D and calcium.
How can I prevent osteoporosis?+
Aim for 1.0–1.2 g/kg protein, 1000 mg calcium, and 800–1000 IU vitamin D daily; do regular weight-bearing and resistance exercise; avoid smoking; limit alcohol; address fall risk (vision, footwear, home environment). These steps demonstrably reduce fracture incidence.
What's the difference between T-score and Z-score?+
The T-score compares your bone density to that of a young healthy adult — it drives diagnosis and treatment decisions (≤ -2.5 = osteoporosis). The Z-score compares to age-matched peers and is mainly used in younger patients.

Background

Osteoporosis Risk Calculator: Understand Your 10-Year FRAX Fracture Risk

9 min