الفهرس 
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Abstract
Osteoporosis (OP) is defined as low bone mineral density caused by altered bone microstructure, ultimately predisposing patients to low-impact, fragility fractures.
In Egypt, based on different studies, it has been calculated that 53.9% of postmenopausal women have osteopenia and 28.4% have OP. On the other hand, 26% of men have osteopenia and 21.9% have OP. Salem et al. (2000) reported that 16.7% of 1190 Egyptian menopausal females had lumbar OP. OP awareness has increased in the last 20 years with the introduction of several effective pharmaceutical agents for treating those at high risk.
Bone mineral density (BMD) measured by dual X-ray absorptiometry (DEXA) has been the gold standard for osteoporosis diagnosis in the absence of established fragility fractures. Trabecular bone score (TBS) is one of the most widely used assessments of bone quality. Both BMD and TBS are independent predictors of fragility fractures and are the two pillars of the World Health Organization’s (WHO) clinical definition of osteoporosis
To evaluate the ability of lumbar spine TBS to assess bone microarchitecture and osteoporosis independent of bone mineral density.
This cross-sectional study was conducted at Geriatric inpatient and outpatient clinic, Mansoura university Hospitals. This study was conducted on 45 elderly males (60 years and above) and postmenopausal females aged 50 years or above having one or more clinical risk factors for osteoporosis.
Regarding the validity of Trabecular bone score (TBS) in discriminating osteopenia/osteoporosis from normal, it was revealed that TBS at cutoff value of ≤ 1.422 can discriminate osteopenia/osteoporosis from normal with 86.4% sensitivity, and 43.5% specificity.
TBS has a limited association with direct measurements of bone micro-architecture, can’t be used alone to diagnose primary osteoporosis and may be a useful adjunct to BMD, DEXA and QCT for fracture risk detection and prediction.