Advanced Diagnostic Tools — The Trabecular Bone Score (TBS)
One of the most significant shifts in 2026 is the integration of the Trabecular Bone Score (TBS) into standard DEXA reports. While traditional BMD measures the quantity of bone, TBS evaluates the quality or microarchitecture. It utilizes specialized software to analyze the gray-level texture of the DEXA images, providing an indirect assessment of the bone’s internal "honeycomb" structure.
This score is crucial because many individuals who suffer "fragility fractures" actually have bone density numbers that fall in the normal or osteopenic range. A low TBS indicates that the bone structure is brittle or fragmented, even if the mineral density appears sufficient. By combining BMD and TBS, clinicians can identify up to 30% more patients at high risk for fractures, allowing for earlier pharmaceutical intervention and specialized lifestyle management.