A 73-year-old woman has multiple vertebral compression fractures. If a bone biopsy is performed, what is the most likely finding?

• A. Defective mineralization
• B. Increased collagen staining
• C. Thickening at the cortex
• D. Thinned trabeculae

Answer: (D)

In the context of multiple vertebral compression fractures in an elderly woman, particularly in someone who is likely experiencing osteoporosis, a bone biopsy would reveal thinned trabeculae. Osteoporosis is characterized by a decrease in bone density and alteration in bone microarchitecture, which includes a reduction in trabecular bone. The trabecular bone comprises the inner network of bone found within vertebrae and is crucial for supporting the structural integrity of the spine.

As osteoporosis progresses, the trabecular struts become increasingly thinned and porous, resulting in fragile bones that are more susceptible to fractures. This condition contrasts with normal bone content where the trabecular structure supports the load-bearing capacity of the bone. The finding of thinned trabeculae on a biopsy would be consistent with the diagnostic criteria for osteoporosis and aligns with the pathological changes leading to the observed vertebral compression fractures in this patient.