Dual-energy X-ray absorptiometry has become the standard for the evaluation of osteoporosis. It is useful both for identifying those people who are going to be at risk of fracture in the future, and for monitoring therapy when the measurements are made at the lumbar spine. A useful alternative for the measurement of osteoporosis risk would be ultrasound measurements of the heel. An alternative approach to monitoring therapy would be by measuring the biochemical markers of bone turnover.