Can a calcaneal morphologic index determine the degree of osteoporosis?

The proposal that a scoring system of the radiographic trabecular patterns of the os calcis could be related to degree of osteoporosis was tested. The technique fails as it showed no correlation with actual bone density determined by a Compton scatter technique and because of a low level of observer concordance. Possible reasons for the poor performance of the index developed in India when applied to North Americans are discussed.