Bone resistance to fractures is helped by micro and macrostructures, bone marrow density (BMD), and adjacent tissues (e.g., cartilages, muscles).Such complementary factors shall be analyzed when BMD alone does not explain increased fracture risk (e.g., the presence of desmophytes in the vertebral column).Initial evaluation of fracture risk can be carried out automatically based on a single abdomen or chest computed tomography (CT) when FRAX without BMD is not available.As CT has high radiation exposure risk and cost concerns opportunistic screening of osteoporosis can be done when CT is done for other health conditions (from chest, abdomen, pelvis, and spine).Trabecular bone score (TBS) can assess patients with osteophytes as osteophytes lead to inaccurate BMD measurements.Trabecular bone score and quantitative ultrasound assess different characteristics of bones.Magnetic resonance imaging (MRI) may allow the identification of patients with fracture risk not detected by DXA.
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Agrawal et al. (2024) studied this question.
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