Hi, @geedle12 When I said "I'll be sure to make my next DXA scan a DXA-TBS," the term "DXA-TBS" was just my shorthand term for "a DXA scan with a setting to also figure a Trabecular Bone Score (TBS)." I used that term "DXA-TBS" a day or two ago, when I thought that, in order to figure a TBS score, we had to ask for the TBS score to be set *during the DXA scan session," but now I'm getting the opposite info! It was American Bone Health organization who told me that I can't give my DXA scan to a facility who has TBS equipment and ask them to analyze it to figure out a TBS score *after the fact* (meaning months after my DXA was already performed). But Dr Keith McCormick seems to be telling me the opposite; he seems to be saying that I CAN in fact send my May 2022 DXA scan to a facility who has TBS software, and have them determine the score from my May 2022 DXA scan. I'm not clear yet if the facility has to be the same exact facility who did my DXA; I don't see why it would have to be, but who knows. I'll get to the bottom of this eventually!!! Sorry if I'm confusing you even more at this point. I tend to get thick into the weeds on everything.

Hi @geedle12, here's an explanation I found at PubMed.gov, quoted from Bone 2017 Nov; 104;66-72.

"Trabecular bone score (TBS) is a texture index derived from standard lumbar spine dual energy X-ray absorptiometry (DXA) images and provides information about the underlying bone independent of the bone mineral density (BMD). Several salient observations have emerged. Numerous studies have examined the relationship between TBS and fracture risk and have shown that lower TBS values are associated with increased risk for major osteoporotic fracture in postmenopausal women and older men, with this result being independent of BMD values and other clinical risk factors. Therefore, despite being derived from standard DXA images, the information contained in TBS is independent and complementary to the information provided by BMD and the FRAX® tool. A procedure to generate TBS-adjusted FRAX probabilities has become available with the resultant predicted fracture risks shown to be more accurate than the standard FRAX tool. With these developments, TBS has emerged as a clinical tool for improved fracture risk prediction and guiding decisions regarding treatment initiation, particularly for patients with FRAX probabilities around an intervention threshold. In this article, we review the development, validation, clinical application, and limitations of TBS.

Dexa (or, more properly, DXA) refers to the Bone Mineral Density, from a bone scan DXA scan, while TBS Traebecular bone score is another test that measures the microarchitecture of the bone. The FRAX tool calculates the risk of fracture, based on information provided by the user. That can be found on line at American Bone Health and other organizations.