The Singh Index, which describes trabecular patterns in the proximal f
emur, has been used as a predictor for hip fractures and as an indicat
or of osteopenia. Evidence suggests that its contribution to the asses
sment of hip fracture risk is in its description of the structural pro
perties of the femur. However, subjectivity in its determination may l
imit its practical value. In this study, we have used computer texture
analysis to characterize the textural changes in trabecular bone whic
h occur in osteoporosis. Texture analysis of the proximal femur was us
ed to rank radiographs of 25 cadaver femora by Singh grading. These ra
nkings were compared with those performed by two experienced radiologi
sts. The computer method performed better than the least consistent in
dividual radiologist, but not as well as the two radiologists in combi
nation. The method required no radiologist's time after the system had
been 'trained' from a set of example radiographs. The method has pote
ntial for use in large studies in which speed and consistency of measu
rement are important.