SUMMARYThe active shape model (ASM) has been widely adopted by automated bone segmentation approaches for radiographic images. In radiographic images of the distal radius, multiple edges are often observed in the near vicinity of the bone, typically caused by the presence of thin soft tissue. The presence of multiple edges decreases the segmentation accuracy when segmenting the distal radius using ASM. In this paper, we propose an enhanced distal radius segmentation method that makes use of a modified version of ASM, reducing the number of segmentation errors. To mitigate segmentation errors, the proposed method emphasizes the presence of the bone edge and downplays the presence of a soft tissue edge by making use of Dual energy X-ray absorptiometry (DXA). To verify the effectiveness of the proposed segmentation method, experiments were performed with 30 distal radius patient images. For the images used, compared to ASM-based segmentation, the proposed method improves the segmentation accuracy with 47.4% (from 0.974 mm to 0.512 mm).