The invention provides method, system and device for determining trabecular bone structure and strength by digital topological analysis, and offers, for the first time, a demonstration of superior associations between vertebral deformity and a number of architectural indices measured in the distal radius, thus permitting reliable and noninvasive detection and determination of the pathogenesis of osteoporosis. A preferred embodiment provides imaging in three dimension of a region of trabecular bone, after which the 3D image is converted into a skeletonized surface representation. Digital topological analysis is applied to the converted image, and each image voxel is identified and classified as a curve, a surface, or a junction; and then associated with microarchitectural indices of trabecular bone to quantitatively characterize the trabecular bone network. The invention is applicable in vivo, particularly on human subjects, or ex vivo.