Trabecular bone score (TBS) enhances assessment of fracture risk in older women and men across many race/ethnicities and with a broad range of comorbidities. The best validated clinical utility of TBS is for input in the FRAX algorithm to modify assessment of fracture risk in patients who are close to FRAX-based intervention thresholds, thereby possibly influencing treatment decisions. TBS has been shown to increase with anabolic therapy and to a lesser degree with denosumab. TBS-adjusted T-scores may be useful with treatment guidelines that do not include FRAX.
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