Photoacoustic (PA) techniques provide optical absorption contrast and spatial information at an ultrasound resolution in deep biological tissues. Among the greatest challenges encountered in the PA examination of bone is the analysis of trabecular bone, which holds key chemical and physical information required for bone health assessments. Ultrasound detection is naturally registered with PA detection; therefore, in this study, we propose ultrasound guidance for the PA detection of trabecular bone. We perform both numerical simulations and an in vivo experiment on a human subject to investigate the possibility of ultrasound-guided detection and segmentation of photoacoustic signals from bone tissue in vivo in a non-invasive manner. The results obtained from the simulation and in vivo experiment suggest that the ultrasound-guided PA method can distinguish PA signals from trabecular and cortical bones as well as from the overlying soft tissue. Considering that the PA technique is non-ionizing and non-invasive, it holds potential for clinical bone health assessment.