**Abstract**

The definition, diagnosis and treatment plans for osteoporosis and osteopenia are based on the assessment of BMD by DEXA. However, this method faces many limitations and challenges. The main difficulty is its ability to assess fracture risk. The threshold for evaluating osteoporosis or osteopenia is of high specificity but of low sensitivity. The majority of osteoporotic fractures occur in individuals whose BMD values are above the osteoporotic threshold. These limitations necessitated the search for alternative solutions of better quality, including radiological and genetic ways, and applications with more input risk factors used in fracture risk assessment like FRAX application. Genetic diagnosis of osteoporosis is a real scientific revolution. There are thousands of point mutations implicated in osteoporosis. The future hope is to find a genetic diagnostic method for osteoporosis. This is very necessary because the treatments currently used are to delay the progression of osteoporosis; therefore, an earlier intervention will be effective. In addition, it serves the future prospects for gene therapy for osteoporosis.

**Keywords:** genetics diagnosis, DEXA, LRP5rs121908669, COL1A2rs72658152, FRAX, osteoporosis
