The FRAX Fracture Risk Tool

The FRAX tool is a free, online calculator developed by the World Health Organization (WHO) at the University of Sheffield. It estimates your 10-year probability of sustaining a major osteoporotic fracture (hip, spine, wrist, or shoulder) based on a combination of risk factors.

What Does FRAX Calculate?

FRAX provides two probability estimates:

• 10-year probability of a major osteoporotic fracture — covering hip, clinical spine, wrist, or shoulder fractures
• 10-year probability of a hip fracture — the most clinically significant individual fracture site

These are expressed as percentages. For example, a 10-year hip fracture probability of 8% means that, based on your risk factors, approximately 8 out of 100 people like you would be expected to have a hip fracture in the next 10 years.

What Information Does FRAX Use?

FRAX takes the following inputs:

If you have had a DXA scan, entering your femoral neck (hip) bone density result will make the FRAX calculation more accurate. However, FRAX can still provide useful estimates without a DXA result.

How to Use the FRAX Tool

1. Go to www.sheffield.ac.uk/FRAX/
2. Select Ireland from the country list
3. Enter your details — age, sex, weight, height, and answer the yes/no questions about risk factors
4. If you have a DXA result, enter your femoral neck BMD (the radiographer's report will include this number)
5. Click “Calculate” — your results appear immediately

Print or save your results and bring them to your next GP appointment. Your GP can use your FRAX score alongside other clinical factors to decide whether treatment is recommended.

How Do GPs Interpret FRAX Scores?

GPs use national and international guidelines to determine at what FRAX threshold treatment should be considered. In general:

• A high FRAX score (above the intervention threshold for your age) typically indicates that medication should be strongly considered, even without a DXA scan
• An intermediate score may prompt a DXA scan to refine the risk estimate before deciding on treatment
• A low score may mean treatment is not currently recommended, but lifestyle measures and monitoring continue

The exact thresholds vary by country and guideline. In Ireland, the FRAX tool is used with Irish-specific fracture probability data and is interpreted against the guidance issued by the Irish Osteoporosis Society and the Royal College of Physicians of Ireland.

FRAX Has Limitations

FRAX is a useful tool but it has limitations:

• It does not capture how many falls a person has, which is an important risk factor
• It does not account for the dose of steroids (any current use is treated the same)
• It may underestimate risk in people who have had multiple vertebral fractures
• It is designed for untreated patients and should not be used to assess treatment response

FRAX complements but does not replace a DXA scan. Used together, they give your GP the most complete picture of your fracture risk.