Prevention of osteoporosis is essential to health, quality of life, and independence in the elderly. The accepted diagnostic method for evaluation of fracture risk after osteopenia and osteoporosis is the measurement of bone mineral density with dual-energy x-ray absorptiometry (DEXA). This method is limited because of its low accessibility, high capital costs, and low sensitivity. This study evaluated whether canal diameter is a reliable indicator as a major risk factor for hip fracture in the elderly. The canal-to-diaphysis ratio was measured on plain radiographs in 38 patients with trochanteric hip fracture and compared with this ratio in 39 age-matched patients with no hip fracture. Comparison was done with the Shapiro-Wilk test and the likelihood ratio test.