Studies of bone remodeling using bone biopsy and biochemical markers of bone turnover measured in serum and urine are important for investigating how new treatments for osteoporosis affect bone metabolism. Positron emission tomography with ¹⁸F sodium fluoride (¹⁸F NaF PET) for studying bone metabolism complements these conventional methods. Unlike biochemical markers, which measure the integrated response to treatment across the whole skeleton, ¹⁸F NaF PET can distinguish changes occurring at sites of clinically important osteoporotic fractures. Future studies using ¹⁸F NaF PET may illuminate current clinical problems, such as the possible association between long-term treatment with bisphosphonates and atypical fractures of the femur.