© 2016 Association for Radiologic & Imaging Nursing. The incidence of osteoporosis and osteoporotic-related fractures continues to increase with the aging population. Early diagnosis of low bone mineral density with dual-energy absorptiometry (DXA) and appropriate treatment can prevent fractures. Accurate DXA imaging and patient education regarding the importance of DXA screening play a critical role in patient management. Recognition of osteoporotic fractures on X-ray at the time of an injury or incidentally during imaging for other indications can lead to early treatment and prevention of future fractures. Radiology nurses and other providers are strategically positioned to impact patient outcomes. An overview of osteoporosis, diagnosis, screening guidelines, and nuances of DXA imaging are provided. Case studies provide the clinician with a summary and application of content.