MINI REVIEW article
Front. Endocrinol.
Sec. Bone Research
Bone Mineral Density Assessment by DXA in Disease-Associated Osteoporosis: The Limitations
1. University of Kentucky, Lexington, United States
2. NYU Langone Health, New York, United States
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Abstract
Measuring bone density by DXA is a routine means of predicting fracture risk. These 2– dimensional images have limitations and may underestimate the risk of fracture due to inadequate evaluation of bone strength. The inclusion of clinical risk factors, calculating FRAX and adding TBS values all improve our ability in bone screening by DXA. However, secondary osteoporosis is not always associated with classical risk factors for bone loss. In addition, unrecognized underlying conditions may contribute to further bone loss and increased risk of low trauma fracture. Therefore, new technologies that assess bone microarchitecture, such as HR-pQCT, can improve our risk assessment for fragility fracture.
Summary
Keywords
BMD, DXA, FRAX, HR-pQCT, TBS
Received
15 December 2025
Accepted
20 February 2026
Copyright
© 2026 Asadipooya and Greene. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Loren Wissner Greene
Disclaimer
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