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A fracture detected as a radiographic observation alone a morphometric vertebral fracture counts as a previous fracture. A prior clinical vertebral fracture or a hip fracture is an especially strong risk factor. The probability of fracture computed may therefore be underestimated.

Fracture probability is also underestimated with multiple fractures. These risk factors appear to have a dose-dependent effect, i. This is not taken into account and the computations assume average exposure. Clinical judgment should be used for low or high exposures.

RA is a risk factor for fracture. However, osteoarthritis is, if anything, protective. For this reason reliance should not be placed on a patient's report of 'arthritis' unless there is clinical or laboratory evidence to support the diagnosis.