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To compare the diagnostic sensitivity of posteroanterior and lateral dual x-ray absorptiometry (PA-DXA, L-DXA, respectively) and quantitative computed tomography (CT). Among 108 women undergoing lumbar spine bone mineral density assessment, 66 were healthy (mean age, 52.9 years +/- 1.2 [standard error of mean]) and 42 had osteoporosis (mean age, 66.9 years +/- 1.2). Although both L-DXA and PA-DXA correlated well with quantitative CT (r = .73 and .72, respectively; P < .0001), L-DXA correlated better than PA-DXA with age (r = -.69 and -.50, respectively; P < .0001). Women with osteoporosis showed higher bone loss with quantitative CT (1.33% per year) and L-DXA (0.3% per year) than with PA-DXA (0.07% per year). Logistic regression analysis indicated that quantitative CT and L-DXA but not PA-DXA are significant predictors of osteoporotic …