What is a trabecular bone score (TBS) and how is it used?
TBS is a newer technique developed to evaluate bone quality. TBS uses data from existing DXA lumbar spine images to produce a gray-level textural index that correlates well with fracture risk in postmenopausal women and in men aged >50 years. It can be used in conjunction with DXA to assist with decisions about initiation of osteoporosis therapy. TBS can also be entered into the FRAX Risk Assessment tool. It should not be used alone as it is not validated as a tool for monitoring therapy. TBS is particularly useful in disorders for which DXA alone significantly underestimates fracture risk, such as GIOP and diabetes mellitus.