Osteoporosis is characterized by low bone mass and increased risk of fractures. The disease is particularly dangerous because it is often “silent.” There are no signs and symptoms while the bone loss occurs in the background. In fact, the condition is typically diagnosed when a significant medical event such as a fragility fracture occurs. Sometimes, even fractures are not recognized clinically (2 out of 3 vertebral fractures are asymptomatic). X-ray techs and DXA operators are in a unique position to recognize osteoporosis fracture risk.