[Conclusion #] Based on the FRAX fracture risk model, the 10-year probability for major osteoporotic fracture is [%] and that for hip fracture is [%].  

This 10-year fracture risk estimate was calculated using the risk factors noted in the history above, along with the femoral neck bone density.  FRAX is intended to help guide treatment decisions in men over age 50 and postmenopausal women with low bone mass (osteopenia).   

The National Osteoporosis Foundation (NOF) recommends that FDA-approved medical therapies be considered in postmenopausal women and men age 50 years and older with low bone mass whose 10-year fracture probability by FRAX is >= 20% for major osteoporotic fracture or >= 3% for hip fracture.

However, all treatment decisions require clinical judgment and consideration of individual patient factors, including patient preferences, comorbidities, previous drug use, risk factors not captured in the FRAX model (e.g., frailty, falls, vitamin D deficiency, increased bone turnover, interval significant decline in bone density) and possible under- or overestimation of fracture risk by FRAX.   

[Conclusion #] Calculation of fracture risk using the FRAX model is not appropriate in certain settings.  It was not performed in this patient because the patient met one or more of the following conditions:  pre-menopausal status, man < age 50, normal bone density, use of hormonal therapy within 1 year, use of anti-resorptive therapy within 2 years, or bilateral hip replacements.

[< > Select and complete the appropriate conclusion above, and delete the other one]