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Bone Mineral Density is NOT Equivalent to Bone Strength
'As you can see there are a number of insurmountable problems with the WHO's definitions, but perhaps the most fatal flaw is the fact that the Dual energy X-ray absorpitometry device (DXA) is only capable of revealing the mineral density of the bone, and this is not the same thing as bone quality/strength.
While there is a correlation between bone mineral density and bone quality/strength – that is to say, they overlap in places -- they are not equivalent. In other words, density, while an excellent indicator of compressive strength (resisting breaking when being crushed by a static weight), is not an accurate indicator of tensile strength (resisting breaking when being pulled or stretched).
Indeed, in some cases having higher bone density indicates that the bone is actually weaker.
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