Trabecular bone score – the newest diagnostic tool for patients with osteoporosis and osteopenia from different pathologies

The trabecular bone score (TBS) is a recently developed instrument that performs gray-level bone texture measurements on dual X-ray absorptiometry (DXA) images of the lumbar spine and thus captures data on trabecular microarchitec-ture. This paper highlights a review of the scientific literature, using PRISMA methodology. A low TBS value is associat-ed with an increase in both prevalent and incident fractures, which is partially independent of both clinical risk factors and areal BMD (aBMD) at the lumbar spine and proximal femur. TBS is related to bone microarchitecture and provides skeletal information that is not captured by standard bone mineral density (BMD) measurements. A low TBS value cor-relates with poor skeletal microstructure; an increased TBS value correlates with better skeletal microstructure. Based on these data, TBS at the lumbar spine is promising as an emerging technology that could become a valuable clinical tool in diagnosing osteopenia and osteoporosis and assessing fracture risk.