[Osteoporosis: diagnostic assessment]

Osteoporosis is a generalized disease of bone that increases the fracture risk. Among the multiple factors involved in osteoporosis, some, but not all, are related to bone mass. Although bone mineral density (BMD) measurement is specific for detecting high-risk individuals, it misses a notable proportion of individuals who have clinical or epidemiological risk factors for osteoporotic fractures. Therefore, composite scores that rely both on BMD and on validated clinical risk factors have been developed. The Fracture Risk Assessment Tool (FRAX) was designed to predict the 10-year probabilities of sustaining a major osteoporotic fractures or a hip fracture. The cutoff value beyond which treatment should be initiated needs to be determined, based not only on clinical criteria, but also on economic considerations.