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Increases in cortical porosity (Ct.Po) and decreases in cortical thickness (Ct.Th) are associated with increased bone fragility. The purpose of this study was to validate an autosegmentation method for highresolution peripheral quantitative computed tomography (HRpQCT) scans to measure Ct.Po and Ct.Th and use it to compare Ct.Po and Ct.Th between pre and postmenopausal women with normal, osteopenic, and osteoporotic areal bone mineral density (aBMD). The Ct.Po and Ct.Th measurements were validated using cadaver forearms (n = 10) and microcomputed tomography (µCT) as the gold standard. The analysis was applied to distal radius and tibia HRpQCT scans from a subset of participants from the Calgary, Alberta, cohort of the Canadian Multicentre Osteoporosis Study (n = 280, 18 to 90 years). Analysis of covariance compared Ct.Po and Ct.Th outcomes between 63 normal …