When to treat osteoporosis

When should we consider treatment of osteoporosis? What is the best method to guide decision-making (Fracture Risk Assessment Tool, densitometry)?

Jonathan Adachi: There are several reasons for treating and really, it is the identification of a high-risk individual. So how do we define high risk? A high-risk individual is somebody who has already sustained a spine fracture or a hip fracture, but today we have got tools that will help us identify individuals even before they have fractures. The World Health Organization under the leadership of John Kanis has developed the Fracture Risk Assessment Tool (FRAX), which can be used with or without a bone density unit and will identify those who are at increased risk of fracturing and who would benefit from intervention.