It doesn’t have to be.”I think Adler completely misses the mark on the reality of the meaning of the word diversity in the context of diversity, equity and inclusion programs. DEXA measures bone mineral density, while TBS analyzes the texture of the image to estimate bone micro-architecture — the internal strength and quality of bone. This distinction matters because bone density alone does not fully predict fracture risk. This issue is especially important for smaller-framed women, whose naturally smaller bones can appear to have low bone density despite adequate bone strength. Given its value and inclusion in osteoporosis guidelines, TBS should be a routine part of DEXA interpretation.