The tale of the T-score: review and perspective

The T-score is well known to anyone working in the field of bone densitometry. It is the primary output from a bone densitometry system and is most often used for diagnosis of osteoporosis and for making treatment decisions. Despite widespread acceptance of the T-score, most clinicians are unfamiliar with the historical evolution of the T-score as a clinical measure. Furthermore, evidence is mounting that the T-score is not the optimal diagnostic parameter for clinical decision making. Many additional risk factors have been reported which can be combined with bone density results to assess absolute fracture risk. This editorial provides an historical review of the T-score, followed by summary of the status of the T-score, and concludes with suggestions for the future use of the T-score in bone densitometry.