Osteoporosis is a common disease that is characterized by low bone mass with microarchitectural disruption and skeletal fragility, resulting in an increased risk of fracture, particularly at the spine, hip, wrist, humours, and pelvis . Osteoporotic fractures (fragility fractures, low-trauma fractures) are those occurring from a fall from a standing height or less, without major trauma such as a motor vehicle accident. There were an estimated nine million osteoporotic fractures worldwide in 2000, of which 1.6 million were hip, 1.7 million forearm, and 1.4 million clinical vertebral fractures [2]. Fractures of the hip and spine are associated with an increased mortality rate of 10 to 20 percent [1,3]. Fractures may result in limitation of ambulation, depression, loss of independence, and chronic pain [4,5]. Properties that contribute to bone strength include bone mineral density (BMD), bone geometry (size and shape of bone), degree of mineralization, microarchitecture, and bone turnover [6]. BMD measurements are available to many patients, and fracture risk has been demonstrated to increase with decreasing BMD [6]. Assessment of bone microarchitecture requires methodologies such as high-resolution peripheral quantitative computed tomography (HR-pQCT), high-resolution magnetic resonance imaging (HR-MRI) or micro MRI, or double tetracycline-labeled transiliac bone biopsy with histomorphometry, which are not routinely used in clinical practice.