The radiologists have several important roles and responsibilities in the imaging of osteoporosis. We need to diagnose osteoporosis, alert clinicians to increased fracture risk, monitor treatment and correctly interpret fragility fractures. In addition we need to ensure that the proper imaging modality is used whenever possible, that is, if DXA has limitations, an attempt should be made to use quantitative CT, and if this is not possible we need to indicate the limitations in our report to the referring clinician. Also, we are responsible for quality assurance of quantitative measurements and we should be a driving force in developing new techniques to analyze bone quality. In recent years, new imaging modalities such as micro-CT and high-resolution magnetic resonance imaging have been developed in an attempt to help diagnose osteoporosis in its early stages, thereby reducing social and economic costs and prevent¬ing patient suffering.