Important: This page provides general information only. It is not a substitute for professional medical advice, diagnosis, or treatment. If you have concerns about your bone health, please speak to your doctor.

The FRAX Score: Fracture Risk Calculator

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.

Access the FRAX Tool

The official FRAX tool is freely available online. Select “Ireland” as your country for the most relevant fracture probability data.

Open FRAX Calculator

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:

Age

Risk increases significantly with age

Sex

Male or female

Weight & height

Low body weight increases risk

Previous fracture

Any prior adult fracture, even minor

Parent hip fracture

Family history of hip fracture

Smoking

Current smoking increases risk

Glucocorticoids

Current or previous use of corticosteroids

Rheumatoid arthritis

An independent risk factor for fracture

Secondary osteoporosis

Conditions causing bone loss (coeliac, etc.)

Alcohol

3+ units/day increases risk

Femoral neck BMD

Optional but improves accuracy if DXA available

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

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

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

Using the Irish FRAX Model

FRAX is not one calculator but a family of them. Each country has its own model, built on that country's fracture and mortality data, and the results are not interchangeable. Ireland has its own model, and selecting it is not a formality — the same set of answers can produce a meaningfully different probability under a different country's model.

Select Ireland before you calculate. The country list is at the top of the calculator. If you leave it on the default, or pick the UK because it looks close enough, your result is being scored against the wrong population.

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 doctor the most complete picture of your fracture risk.

FRAX Score: Common Questions

What is a FRAX score?

A FRAX score is your estimated probability, as a percentage, of breaking a bone in the next 10 years. The calculator returns two numbers: the risk of a major osteoporotic fracture, meaning hip, spine, forearm or shoulder, and separately the risk of a hip fracture. It was developed at the University of Sheffield and is used worldwide.

Is there an Irish version of the FRAX calculator?

Yes. The FRAX calculator has a country setting, and Ireland has its own model built on Irish fracture and mortality data. Selecting Ireland matters, because the same person can get a noticeably different result under another country's model. Always select Ireland from the country list before you calculate.

How do I interpret my FRAX score?

There is no single number that means danger. FRAX results are read against an intervention threshold that rises with age, so a 15 percent major fracture risk means something quite different at 55 than at 80. In broad terms a high result supports starting treatment, an intermediate result usually prompts a DXA scan to refine the estimate, and a low result means lifestyle measures and review. Your doctor makes that call, not the calculator.

Can I calculate a FRAX score without a DXA scan?

Yes, and that is one of the reasons it exists. FRAX will run on your age, sex, height, weight and risk factor answers alone. Adding your femoral neck bone density from a DXA report makes the estimate more accurate, but the tool is deliberately usable before anyone has been scanned, which helps decide who needs a scan in the first place.

What does FRAX not take into account?

Several things that genuinely matter. It does not count how many times you have fallen, it treats any steroid use the same regardless of dose, it can underestimate risk in people with multiple spinal fractures, and it is designed for people not already on treatment. This is why it supports a clinical decision rather than replacing one.

Talk to Your Doctor

Your FRAX score should be interpreted by your doctor alongside other clinical information. Discuss your result at your next appointment.

You can say: “I'd like to discuss my bone health and whether I should have a DXA scan.”

Questions to Ask Your Doctor

Last reviewed: February 2026 — FragilityFracture.ie Editorial Team