A method, system, and computer program product for analyzing a medical image to determine a measure of bone strength, comprising identifying plural regions of interest (ROIs) in the medical image; calculating at least one texture feature value for each ROI; averaging the at least one texture feature value calculated for each ROI to obtain at least one average texture feature value; and determining the measure of bone strength based on the at least one average texture feature value using a classifier. Alternatively, the image data in each ROI is first transformed into the frequency domain and averaged to obtain an average image. This process reduces noise and improves the performance of the system. The assessment of bone strength and/or osteoporosis is used as a predictor of risk of fracture.