Question
A 79-year-old female presents with a complaint of chronic and progressive mid-back pain for several months but no other symptoms. Spinal x-rays reveal two compression fractures of the T10 vertebral body. Calcium, phosphate and alkaline phosphatase levels are within the reference range. Histological examination of the affected vertebral bone most likely will reveal which of the following?
| A. |
Bony necrosis with acute and chronic inflammation and granulomas
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| B. |
Thin trabeculae disconnected from each other
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| C. |
Thickened, irregular trabeculae with prominent cement lines
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| D. |
Thinning of the cortical and trabecular bone
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Show Answer
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Correct Answer � B
Explanation
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Answer B) Thin trabeculae disconnected from each other
This woman is suffering from postmenopausal osteoporosis.
In such patients, the calcium and phosphate levels typically are within the reference range.
The alkaline phosphatase usually is normal but may be increased following fractures.
Microscopic examination of affected bones will reveal thin trabeculae disconnected from each other and an increase in osteoclastic activity (may be uneven) or an increased percentage of the surface area with resorptive pitting.
Complications of Osteoporosis
Bone fractures, particularly in the spine or hip, are the most serious complications of osteoporosis.
Hip fractures often are caused by a fall and can result in disability and even an increased risk of death within the first year after the injury.
In some cases, spinal fractures can occur even if you haven’t fallen. The bones that make up the spine (vertebrae) can weaken to the point of crumpling, which can result in back pain, lost height and a hunched forward posture.
