Objective: Osteoporosis (OP) is a major cause of disability, morbidity and mortaliy. Causes are significant economic burden with fractures. Dual energy X-ray absorptiometry (DXA) is the only technique that is defined as the gold standard that the World Health Organization currently recommends in determining the fracture risk. The use of direct radiographic examinations is recommended for the causes of false negative results in densitometric examination and for the detection of fracture presenting as OP indicator in clinical practice. The purpose of this study is a retrospective investigation of the need for DXA methodology, which we routinely use for diagnosis, treatment and follow-up of OP, in patients with fractures by direct radiography.