High-resolution peripheral quantitative computed tomography (HR-pQCT) is a promising in vivo imaging technique that can be used to assess the three-dimensional microstructure of the radius and tibia. Micro finite element models can also be constructed from these images to estimate the mechanical competence of these sites, giving this technique the potential in the clinical diagnosis of osteoporosis. However, the mechanical properties of the peripheral sites may not be predictive of the properties at the central sites. Image-based finite element analysis was performed on sixty-nine premenopausal women, 12 with idiopathic osteoporosis and 57 normal controls, who underwent HR-pQCT scans of the distal radius and distal tibia and central quantitative computed tomography scans of the proximal femur and lumbar spine. Significant correlations were found between the stiffness of the two peripheral sites (r=0.86), the two central sites (r=0.49) and also between the peripheral and central skeletal sites (r=0.56-0.70).