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Semin Musculoskelet Radiol 2024; 28(05): 539-546
DOI: 10.1055/s-0044-1788886
Review Article

Trabecular Bone Score to Enhance Fracture Risk Prediction and Treatment Strategies in Osteoporosis

Guillaume Gatineau
1   Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland
,
Didier Hans
1   Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland
,
Karen Hind
2   Wolfson Research Institute of Health and Wellbeing, Durham University, Durham, United Kingdom
3   Medical School, Lancaster University, Lancaster, United Kingdom
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Abstract

The Trabecular Bone Score (TBS), a gray-level textural assessment derived from dual-energy X-ray absorptiometry images, serves as a validated index of trabecular bone microarchitecture. Over the past decade, significant evidence has highlighted the usefulness of TBS in primary and secondary osteoporosis, leading to its integration with the Fracture Risk Assessment Tool (FRAX) and bone mineral density (BMD) T-score adjustments. This review explores the role of TBS in fracture prediction, treatment initiation, and monitoring. Studies confirm that TBS enhances fracture risk prediction in both primary and secondary osteoporosis when combined with BMD and clinical risk factors. Evidence also suggests that including TBS alongside BMD and FRAX offers significant potential for treatment stratification, considering the overall skeletal profile, such as bone mass, bone quality, and clinical risk factors. Consequently, TBS has become a standard part of clinical care worldwide. Future enhancements hope to adjust for soft tissue thickness, broadening the applicability of TBS across diverse body types and pediatric populations.

Keywords

Trabecular Bone Score - fracture - osteoporosis - treatment


Publication History

Article published online:
15 October 2024

© 2024. Thieme. All rights reserved.

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