A bone

biopsy A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a diseas ...

is a procedure in which a small

bone A bone is a Stiffness, rigid Organ (biology), organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red blood cell, red and white blood cells, store minerals, provid ...

sample is removed from the outer layers of bone for examination, unlike a

bone marrow biopsy Bone marrow examination refers to the pathologic analysis of samples of bone marrow obtained by bone marrow biopsy (often called trephine biopsy) and bone marrow aspiration. Bone marrow examination is used in the diagnosis of a number of conditio ...

, which involves the innermost part of the bone. The bone biopsy sample retains the architecture of bone when seen using histopathological examination slide. __TOC__

Technique

The technique of bone biopsy allows the histomorphometric analysis of the bone samples obtained from the

iliac crest The crest of the ilium (or iliac crest) is the superior border of the wing of ilium and the superiolateral margin of the greater pelvis. Structure The iliac crest stretches posteriorly from the anterior superior iliac spine (ASIS) to the posterior ...

. Therefore, it can provide a direct assessment of regional bone metabolism. Hence, the reason why this method is considered the gold-standard technique for measuring bone remodelling. Patients undergo double tetracycline labelling, and then samples of bone are collected using trephine under local anesthetic from the iliac crest as it is the only readily accessible site for bone biopsy. This technique is subject to large measurement errors; it is complex and costly to perform and is invasive, meaning that it is painful to the patients. For these reasons, a bone biopsy is not readily acceptable to patients. Moreover, multiple biopsies using double tetracycline labelling are necessary for the same patient to assess treatment response or disease progression. Another drawback is that the iliac crest may not provide a true measurement of changes in bone metabolism at the lumbar spine or hip as considerable differences in regional bone metabolism estimates are observed at different skeletal sites. Revell et al. describes the measurement of various parameters such as trabecular bone volume, osteoid volume, osteoid surface, active osteoblastic surface, resorption surface, osteoclastic resorption surface, mineralization front, osteoid index, appositional rate, and osteoclastic index via histomorphometric analysis of bone samples. If a biopsy is to be obtained along with medical imaging examinations, as a rule, biopsy should be done after all necessary imaging has been performed. A bone biopsy can also be used to find out if

cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...

, or

infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...

, or other abnormal cells are present in the bone tissue.

References

{{Reflist Biopsy Bones