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Science & evidence
Bone density is not bone quality
The science behind Trabecular Bone Score®: How bone microarchitecture determines fracture risk, and the evidence that's made TBS® the global standard for assessing it.
The core idea
Two bones with the same density can carry very different risk
Bone mineral density (BMD) measures how much bone is present. But strength also depends on how that bone is built (its microarchitecture). TBS® makes that structural dimension measurable from a routine DXA scan, so patients hiding in a "normal" density are no longer missed.
Explore the science
From the method to the evidence
Everything behind TBS®: The analytic method, the biology, the clinical applications, and the published record.
Trabecular Bone Score
What TBS® is, and how BMD and TBS® complement each other to assess fracture risk
Bone microarchitecture
The internal structure of bone, and why it determines strength, independent of density
TBS in secondary osteoporosis
How disease and treatment degrade bone quality, including cancer, diabetes, HIV, endocrine, and more
Publications
A selection of peer-reviewed literature, filterable by topic, and indication
Evidence at a glance
More than a decade of validation
4.5M+
TBS® evaluations performed annually1
1,600+
peer-reviewed publications1
35+
clinical guidelines citing TBS®1
90+
countries with clinical deployments1
Clinically proven
TBS evidence keeps growing
2026 · eClinicalMedicine
Gatineau, G., De Gruttola, M, et al.
2026 · Archives of Osteoporosis
The Effects of Spaceflight Countermeasures on Trabecular Bone Score (TBS) of the Lumbar Spine
Anderson, K.D., Spector, E.R., et al.
2026 · Transplantation
Kratochvílová, S., Brunová, J., et al.
We help clinicians reveal more from routine imaging — every patient, every scan — for better care.
References (1)
1. Medimaps Group (2026) Internal data (data on file).