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Bone health

FRAX score explained

The ten-year fracture risk calculator that turns your age, history and bone density into a treatment decision.

Key facts

At a glance

  • What it is: a questionnaire-based calculator estimating your ten-year probability of hip fracture and major osteoporotic fracture.

  • Inputs: age, sex, weight, height, previous fractures, parental hip fracture, smoking, alcohol, steroids, rheumatoid arthritis and optionally your DEXA result.

  • No test needed: FRAX can be run with or without a bone density score - a high result without one is itself a reason to have a DEXA.

  • Results: the score is calculated instantly in clinic or online and mapped against UK treatment thresholds.

  • Follow-up: your GP or a bone specialist uses the percentage to decide between reassurance, a DEXA scan or starting bone-protecting medication.

The full picture

What this test involves, and how to get it

FRAX is a calculator, not a scan. Developed at the University of Sheffield, it combines your age, sex, body size and a short list of proven risk factors - previous fractures, a parent who broke a hip, smoking, alcohol intake, steroid use and rheumatoid arthritis - to estimate the probability that you will suffer a hip fracture or major osteoporotic fracture in the next ten years. It can be run with or without a bone density result: without one, a raised score is the standard justification for arranging a DEXA; with one, it becomes the main tool for deciding whether treatment is worthwhile.

In the UK, FRAX (or the similar QFracture tool) is built into NHS practice, and your GP can run it in a routine appointment. Privately, it forms part of most menopause consultations, health assessments and bone clinic reviews, where it is paired with same-visit or fast-tracked DEXA scanning - typically available within one to two weeks. The output is a percentage, and what counts as "high" depends on your age, so the number is always worth talking through with a clinician rather than reading in isolation.

A quiet reminder

This guide is for information, not medical advice.

Your own clinician knows your history and can tell you which parts apply to you. Next review of this page: 2027-09-27.

Frequently asked

Common questions about FRAX score explained.

Quick, plain-English answers to what people ask us most.

  • What is the FRAX score?

    FRAX is a calculation tool that estimates your individual risk of breaking a bone, particularly the hip, spine, or wrist, over the next ten years. It combines factors like age, sex, weight, height, and clinical risk factors, and can also incorporate a bone density scan result.

  • Why would a doctor use FRAX?

    It's used to decide whether someone would benefit from a bone density scan or from starting treatment to reduce fracture risk, particularly around the menopause or in older age. It helps target bone health interventions to those who need them most, rather than screening everyone.

  • Do I need to prepare for it?

    No preparation is needed, as FRAX is a calculation based on information you provide, such as your medical history, family history, smoking and alcohol use, and any previous fractures.

  • What happens when FRAX is calculated?

    Your doctor asks a set of standard questions, or you complete them yourself, and the information is entered into the FRAX calculator, which produces a percentage risk score within minutes. It can be done with or without a bone density scan result, though including one improves accuracy.

  • Does it involve any risk or discomfort?

    FRAX itself is just a questionnaire-based calculation and carries no physical risk. If a bone density scan is recommended alongside it, that test is quick and uses a very low dose of radiation.

  • How long do results take?

    The FRAX score is generated immediately once the information is entered, so you'll usually get your result during the same consultation.

  • What does an abnormal score mean, and what happens next?

    A higher score suggests an increased likelihood of fracture and may prompt a bone density scan, lifestyle advice, or a discussion about medication to strengthen bones. A lower score is reassuring but your doctor may still suggest general bone health measures like exercise and vitamin D.

  • How much does it cost privately, and is it available on the NHS?

    FRAX assessment is freely available on the NHS as part of routine care, often alongside a GP or specialist consultation. Private clinics can offer a more in-depth assessment alongside bone density scanning, with cost varying by provider.

  • Is FRAX accurate and reliable?

    FRAX is a well-validated, internationally used tool, though like any risk calculator it gives an estimate rather than a certainty, and works best when combined with a bone density scan. It's most useful as a guide to inform shared decisions with your doctor rather than a standalone diagnosis.

  • How do I book a private assessment, and how quickly can I be seen?

    You can book a private consultation that includes a FRAX assessment and bone density scan if needed, often within a week or two.