FRAX using Sheffield?: I just used a... - Bone Health and O...

Bone Health and Osteoporosis UK

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FRAX using Sheffield?

2019pro•

I just used a Sheffield.ac.uk site for frax, but Im not sure how to interpret the results or if I did it correctly.. it asked for the make of the machine used in the last test (Hologic)?

Mine came back as major osteoporotic 34% and hip as 3.7%

That doesn't sound too good to me? could it be that high because my mother had a fracture I think in late 60/early 70s and I broke my radius 3 years ago? My Dr keeps calling to get the Prolia set up.. more confused.

Age: 63 Female

Weight (kg) 65.8

Height (cm) 165.1

Previous Fracture Yes

Parent Fractured Hip Yes

Current Smoking No

Glucocorticoids No

Rheumatoid arthritis No

Secondary osteoporosis No

Alcohol 3 or more units/day No

Femoral neck BMD (g/cm2) T-score: -2.3 Hologic as the source

BMI: 24.1

The ten year probability of fracture (%) with BMD

Major osteoporotic 34

Hip Fracture3.7

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2019pro

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24 Replies

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HeronNS6 years ago

Let me get this straight. Your t-score is -2.3? That is not osteoporosis (as rather randomly decided by the WHO some years ago). I suspect it is your saying you have had a previous fracture which triggers the high chance of fracture. But what kind of fracture did you have? Was it caused by trauma, or "spontaneous". If it was caused by trauma which was strong enough to break a normal, healthy bone, then your risk of breaking another bone in the future really is no greater than for anyone else in your age group and (apparently) good state of health. If, however, it was a relatively minor event which caused the break, then you should immediately commence a stringent program of diet, supplements and appropriate exercise, similar to this: healthunlocked.com/pmrgcauk...

And you should ask your doctor to check you for secondary causes of osteoporosis before agreeing to any drug treatment:

americanbonehealth.org/bone...

2019pro• in reply toHeronNS6 years ago

Hi -

Thank yall for responding. I will try to answer your question.

I was walking and stepped on a branch, put out my arm and heard it "pop" - fracture of the radius. Other than broken toes -I am clumsy- and a broken leg at age 2. I haven't had any other fractures.

the FRAX used the neck measurements from this year:

neck area 4.66cm total was 29.51

bmc 2.73 22.72

bmd .586 .770

Tscore -2.4 -1.4 from 2016 the t score was also -1.4

peak ref 69 82

zscore -.09 -.03

age match 85 96

the report also shows l1-l4 results as:

area 13.12 12.4 14.33 15.59 Total: 55.43

bmc 10.2 10.23 10.49 12.51 43.43

bmd .778 .825 .732 .802 .783

Tscore -1.9 -1.8 - 3.2 -2.4 -2.4 from 2016 t score was -1.8

peak ref 79 80 68 76 75

zscore - -.5 -.5 -1.5 -.6 -.8

age match 94 97 82 93 90

2019pro• in reply to2019pro6 years ago

QUESTION: what do you think about having another bone density scan at an independent office just to check the results against the one my dr did this year? He is really pushing for the Prolia - at least under the pretense of worrying about future fractures(and maybe that is true) and that is in my future - but I really want to make a good decision based on my results. When I look at the numbers (above that I posted from previous years) - they don't look "that" bad to me when I see others with around the same numbers. But I guess, I don't know what I don't know either.

Met00• in reply to2019pro6 years ago

DEXA scanners aren't accurate enough to be able to compare scores from different machines. You'll almost certainly get different results, which could be better or worse than the ones you already have. If they're worse, you'll just be more worried.

SusanEleven• in reply toHeronNS6 years ago

Thank you for mentioning trauma versus spontaneous fracture. My doctors have always ignored the distinction. I had a fracture about 2 decades ago and they keep pointing to that as evidence of my high risk. I took a tremendous fall on an extremely hard surface!

HeronNS• in reply toSusanEleven6 years ago

I still dispute my ice-related fracture as being "spontaneous". I was in a hurry, taking a shortcut, and was manoeuvering past what I thought was a snowbank. I put all my weight on one leg as I attempted to step into the snow to get past, but it turned out to be solid ice with a veil of freshly fallen snow on it. Because all my weight was on that leg my foot slipped and my leg bent sideways at the knee and I heard a snap. That isn't good, I thought, as I fell (bone broken before the fall). And then when I went to pick myself up the pain on that leg was excruciating. In retrospect it was probably better I broke the bone (tibial plateau, no displacement) than ripped all my ligaments and tendons, but at the time it was devastating as we missed a long-planned holiday in New Zealand. This is counted as a "fragility" fracture.

HeronNS6 years ago

By the way, I just did the calculation myself and my fracture risk is considered higher with this tool than what I was told by the hospital after my DXA scan.

2019pro• in reply toHeronNS6 years ago

that is what is so confusing to me... How the tests can vary so much? I took 3 different ones and got 3 different results. My Dr keeps calling for me to get the Prolia - but I am just too concerned to do it. I am guessing that by the blood tests/ 24 hr urine collection previously mentioned rule out other secondary causes - but how else would I know that?

HeronNS• in reply to2019pro6 years ago

The only tool we have is DXA scan, plus other risk factors like age, medication, fragility fracture. If successive DXA scans are done the results may only be valid if performed on same machine, and I've heard preferably by the same technician. Which doesn't improve one's confidence in the process!

Met006 years ago

There's another fracture risk tool which claims to be more accurate than FRAX. If you're interested, it's QFracture: qfracture.org/

Busymommy• in reply toMet006 years ago

It can’t be more accurate. It doesn’t even ask for Tscores.

Met00• in reply toBusymommy6 years ago

This is where I read about QFracture being more accurate: medscape.com/viewarticle/85.... T-scores are only an estimate of bone density (if they were accurate, you'd be able to compare results from different machines): elainemansfield.com/nutriti...; betterbones.com/testing/how....

2019pro• in reply toMet006 years ago

That gave me 6.1% and 1.6%.. Better odds... But not sure how much I trust either of the scoring😕

HeronNS• in reply to2019pro6 years ago

Not everyone with osteoporosis fractures. Most fractures are sustained by people with normal bones. Falling, not bone density per se, is the greatest risk for fracture.

Met00• in reply to2019pro6 years ago

I prefer to turn the scores around, so if you have a 6% chance of fracturing, that's 94% chance you won't.

2019pro• in reply toMet006 years ago

when I did the ABH calculator it was even worse!

input the last hip score (-2.3)and got this:

Your 10-year risk of any fracture is greater than 45%. The average risk of any fracture for your age is 11%. Your 10-year risk of hip fracture is 10%

No wonder we get confused!

Met00• in reply to2019pro6 years ago

Oh no, that doesn't help at all! What happens if you do it without mentioning the previous fracture?

2019pro• in reply toMet006 years ago

Then it is 30%..11%..7%

Met00• in reply to2019pro6 years ago

Do you live in the US? With Frax, the risk changes, depending on which country you live in! I've tried playing around with Frax and QFracture, inputting different data (country or ethnicity, with or without your previous fracture, with or without your parent's hip fracture) - all of these change the score. QFracture consistently gives you a lower score than Frax. Frax seems to put a lot more weight on yours and your parent's fractures.

2019pro• in reply toMet006 years ago

yes.. In the US...the QFracture was definitely lower - 6% vs 30%+

I totally understand the reasoning behind knowing parent fractures, but still very confused... need a crystal ball for the future..lol

Met00• in reply to2019pro6 years ago

Even a 30% risk of fracture is 70% chance of not fracturing....

HeronNS• in reply toBusymommy6 years ago

It also only asked about specific bones, so I didn't have to include my tibial plateau fracture. I've got a feeling age and gender are the biggest factors. I tried fiddling with the results.... Easier to do than with the Sheffield tool. I took out all the possible risk factors and it was still relatively high. Then made myself heavier, no difference, then tried age, dramatic drop, and gender, even more so! So to really reduce our risk we have to be perfectly healthy young males. I wonder what the precentage of males is who get fractures because they live riskier lives compared to elderly women who are in reasonably good shape?

Met00• in reply toHeronNS6 years ago

Apparently (in the UK anyway) 1 in 2 women and 1 in 5 men over 50 fracture due to osteoporosis! I do question this, as most of the over 50s I know haven't fractured a bone, unless it means 1 in 2 women and 1 in 5 men with osteoporosis will fracture. ageuk.org.uk/information-ad...

lawdog6 years ago

Hi, "frax" is a word I near heard before....my rheumatologist has talked to me about changes in my dexa that concerned another MD; explained the indication of some derease in bone density was very minor and no reason for concern......and the dexa has to be on the exact same equipment that generated the last two reports. He appears to concentrate on the blood tests rather than medical equipment generated data. Thanks for introducing me to "Frax".