Osteoporosis is a major healthcare problem around the world and its importance lies in the fractures that result. A variety of devices are available in India and other Asian countries for bone mineral density (BMD) assessment, but their clinical utility is limited because of non-availability of local normative database. The purpose of this study was to establish the normative reference database for BMD in Indian women and men using digital x-ray radiogrammetry (DXR). Radiographs of the non-dominant hand were obtained on 262 women and 178 men between 20 and 79 years of age following strict inclusion and exclusion criteria. The radiographs were analysed by DXR using pronosco x-posure system V.2 to estimate the BMD (DXR-BMD). The peak value for DXR-BMD in women was 0.588 g/cm2 at age 35 years and 0.602 g/cm2 in men at age 42 years. There were statistically significant differences in BMD in women and men across all age ranges. An age dependent decline in BMD was seen in both women and men over the age of 50 years. The use of DXR should broaden the availability of fracture risk assessments in places where DXA is not available.

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