Anti-resorptive therapy reduces bone fragility and increases bone density. It is likely that the trabecular structure of the bone also changes during treatment. Peripheral densitometry has not been used so far to monitor response to therapy. If the combination of texture analysis and peripheral BMD change reproducibly during treatment it may be possible to employ this combination to monitor therapeutic response. In so doing, one could avoid the need to use the central densitometry and biochemical markers of bone turnover since the former is cumbersome while the latter suffers from low precision.