Bone biopsy

Last updated

A bone biopsy is a procedure in which a small bone sample is removed from the outer layers of bone for examination, unlike a bone marrow biopsy, which involves the innermost part of the bone. The bone biopsy sample retains the architecture of bone when seen using histopathological examination slide.

Technique

The technique of bone biopsy allows the histomorphometric analysis of the bone samples obtained from the iliac crest. 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. [1] 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. [2] 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. [2] [3] [4] [5] [6] [7] For these reasons, a bone biopsy is not readily acceptable to patients. [2] [3] [4] [5] [6] [7] 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. [8]

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, [9] or infection, [10] or other abnormal cells are present in the bone tissue.

Related Research Articles

<span class="mw-page-title-main">Bone</span> Rigid organs that constitute part of the endoskeleton of vertebrates

A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, and enable mobility. Bones come in a variety of shapes and sizes and have complex internal and external structures. They are lightweight yet strong and hard and serve multiple functions.

<span class="mw-page-title-main">Osteoporosis</span> Skeletal disorder

Osteoporosis is a systemic skeletal disorder characterized by low bone mass, micro-architectural deterioration of bone tissue leading to more porous bone, and consequent increase in fracture risk. It is the most common reason for a broken bone among the elderly. Bones that commonly break include the vertebrae in the spine, the bones of the forearm, the wrist, and the hip. Until a broken bone occurs there are typically no symptoms. Bones may weaken to such a degree that a break may occur with minor stress or spontaneously. After the broken bone heals, the person may have chronic pain and a decreased ability to carry out normal activities.

<span class="mw-page-title-main">Parathyroid hormone</span> Mammalian protein found in humans

Parathyroid hormone (PTH), also called parathormone or parathyrin, is a peptide hormone secreted by the parathyroid glands that regulates the serum calcium concentration through its effects on bone, kidney, and intestine.

<span class="mw-page-title-main">Bisphosphonate</span> Pharmaceutical drugs for preventing bone loss

Bisphosphonates are a class of drugs that prevent the loss of bone density, used to treat osteoporosis and similar diseases. They are the most commonly prescribed drugs used to treat osteoporosis. They are called bisphosphonates because they have two phosphonate groups. They are thus also called diphosphonates.

<span class="mw-page-title-main">Paget's disease of bone</span> Disease affecting bone remodeling

Paget's disease of bone is a condition involving cellular remodeling and deformity of one or more bones. The affected bones show signs of dysregulated bone remodeling at the microscopic level, specifically excessive bone breakdown and subsequent disorganized new bone formation. These structural changes cause the bone to weaken, which may result in deformity, pain, fracture or arthritis of associated joints.

<span class="mw-page-title-main">Teriparatide</span> Pharmaceutical drug for treating osteoporosis

Teriparatide, sold under the brand name Forteo, is a form of parathyroid hormone (PTH) consisting of the first (N-terminus) 34 amino acids, which is the bioactive portion of the hormone. It is an effective anabolic agent used in the treatment of some forms of osteoporosis. Teriparatide is a recombinant human parathyroid hormone analog. It has an identical sequence to the 34 N-terminal amino acids of the 84-amino acid human parathyroid hormone.

<span class="mw-page-title-main">Trabecula</span> Tissue element that supports or anchors a framework of parts within a body or organ

A trabecula is a small, often microscopic, tissue element in the form of a small beam, strut or rod that supports or anchors a framework of parts within a body or organ. A trabecula generally has a mechanical function, and is usually composed of dense collagenous tissue. It can be composed of other material such as muscle and bone. In the heart, muscles form trabeculae carneae and septomarginal trabeculae. Cancellous bone is formed from groupings of trabeculated bone tissue.

<span class="mw-page-title-main">Osteocyte</span> Mature osteoblasts which helps in communication between cells and also in molecular synthesis

An osteocyte, an oblate shaped type of bone cell with dendritic processes, is the most commonly found cell in mature bone. It can live as long as the organism itself. The adult human body has about 42 billion of them. Osteocytes do not divide and have an average half life of 25 years. They are derived from osteoprogenitor cells, some of which differentiate into active osteoblasts. Osteoblasts/osteocytes develop in mesenchyme.

<span class="mw-page-title-main">Ossification</span> Development process in bones

Ossification in bone remodeling is the process of laying down new bone material by cells named osteoblasts. It is synonymous with bone tissue formation. There are two processes resulting in the formation of normal, healthy bone tissue: Intramembranous ossification is the direct laying down of bone into the primitive connective tissue (mesenchyme), while endochondral ossification involves cartilage as a precursor.

<span class="mw-page-title-main">Fibrous dysplasia of bone</span> Medical condition

Fibrous dysplasia is a very rare nonhereditary genetic disorder where normal bone and marrow is replaced with fibrous tissue, resulting in formation of bone that is weak and prone to expansion. As a result, most complications result from fracture, deformity, functional impairment, pain, and the impingement of nerves. Disease occurs along a broad clinical spectrum ranging from mostly asymptomatic incidental lesions, to severe disabling disease. Disease can affect one bone (monostotic), multiple (polyostotic), or all bones (panostotic) and may occur in isolation or in combination with café au lait skin macules and hyperfunctioning endocrinopathies, termed McCune–Albright syndrome. More rarely, fibrous dysplasia may be associated with intramuscular myxomas, termed Mazabraud's syndrome. Fibrous dysplasia is very rare, and there is no known cure. While fibrous dysplasia is not itself a form of cancer, in severe cases it may undergo a malignant transformation into cancers such as osteosarcoma or chondrosarcoma, so some clinicians may regard it as precancerous rather than benign.

<span class="mw-page-title-main">Sclerostin</span> Protein-coding gene in the species Homo sapiens

Sclerostin is a protein that in humans is encoded by the SOST gene. It is a secreted glycoprotein with a C-terminal cysteine knot-like (CTCK) domain and sequence similarity to the DAN family of bone morphogenetic protein (BMP) antagonists. Sclerostin is produced primarily by the osteocyte but is also expressed in other tissues, and has anti-anabolic effects on bone formation.

<span class="mw-page-title-main">Osteonecrosis of the jaw</span> Medical condition

Osteonecrosis of the jaw (ONJ) is a severe bone disease (osteonecrosis) that affects the jaws. Various forms of ONJ have been described since 1861, and a number of causes have been suggested in the literature.

<span class="mw-page-title-main">Medication-related osteonecrosis of the jaw</span> Medical condition

Medication-related osteonecrosis of the jaw is progressive death of the jawbone in a person exposed to a medication known to increase the risk of disease, in the absence of a previous radiation treatment. It may lead to surgical complication in the form of impaired wound healing following oral and maxillofacial surgery, periodontal surgery, or endodontic therapy.

Abaloparatide, sold under the brand name Tymlos among others, is a parathyroid hormone-related protein (PTHrP) analog medication used to treat osteoporosis. It is an anabolic agent.

The trabecular bone score is a measure of bone texture correlated with bone microarchitecture and a marker for the risk of osteoporosis. Introduced in 2008, its main projected use is alongside measures of bone density in better predicting fracture risk in people with metabolic bone problems.

<span class="mw-page-title-main">Bone marrow adipose tissue</span>

Bone marrow adipose tissue (BMAT), sometimes referred to as marrow adipose tissue (MAT), is a type of fat deposit in bone marrow. It increases in states of low bone density -osteoporosis, anorexia nervosa/caloric restriction, skeletal unweighting such as that which occurs in space travel, and anti-diabetes therapies. BMAT decreases in anaemia, leukaemia, and hypertensive heart failure; in response to hormones such as oestrogen, leptin, and growth hormone; with exercise-induced weight loss or bariatric surgery; in response to chronic cold exposure; and in response to pharmacological agents such as bisphosphonates, teriparatide, and metformin.

Single photon absorptiometry is a measuring method for bone density invented by John R. Cameron and James A. Sorenson in 1963.

Positron emission tomography for bone imaging, as an in vivo tracer technique, allows the measurement of the regional concentration of radioactivity proportional to the image pixel values averaged over a region of interest (ROI) in bones. Positron emission tomography is a functional imaging technique that uses [18F]NaF radiotracer to visualise and quantify regional bone metabolism and blood flow. [18F]NaF has been used for imaging bones for the last 60 years. This article focuses on the pharmacokinetics of [18F]NaF in bones, and various semi-quantitative and quantitative methods for quantifying regional bone metabolism using [18F]NaF PET images.

Judith Elizabeth Adams was an English professor, musculoskeletal radiologist, honorary consultant, and clinical director of the radiology department at Manchester University NHS Foundation Trust.

Mary Larsen Bouxsein is an American biomechanical engineer and an orthopedic researcher. She is the president of the American Society for Bone and Mineral Research, director of the Centre of Advanced Orthopaedic Studies at Beth Israel Deaconess Medical Center, professor at the department of Orthopedic Surgery at Harvard Medical School. She is known for her work on bone density and the use of imaging to define the factors leading to bone fractures.

References

  1. ↑ Steiniche, Torben (1995). "Bone histomorphometry in the pathophysiological evaluation of primary and secondary osteoporosis and various treatment modalities". APMIS. 103 (S51): 5–44. doi:10.1111/j.1600-0463.1995.tb05544.x. ISSN   0903-4641. S2CID   24954648.
  2. 1 2 3 Compston, J.E.; Croucher, P.I. (1991). "Histomorphometric assessment of trabecular bone remodelling in osteoporosis". Bone and Mineral. 14 (2): 91–102. doi:10.1016/0169-6009(91)90086-f. ISSN   0169-6009. PMID   1912765.
  3. 1 2 Arlot, Monique; Meunier, Pierre J; Boivin, Georges; Haddock, Lillian; Tamayo, Juan; Correa-Rotter, Ricardo; Jasqui, Salomón; Donley, David W; Dalsky, Gail P; Martin, Javier San; Eriksen, Erik Fink (2005). "Differential Effects of Teriparatide and Alendronate on Bone Remodeling in Postmenopausal Women Assessed by Histomorphometric Parameters". Journal of Bone and Mineral Research. 20 (7): 1244–1253. doi: 10.1359/jbmr.050309 . ISSN   0884-0431. PMID   15940379.
  4. 1 2 Jiang, Yebin; Zhao, Jenny J; Mitlak, Bruce H; Wang, Ouhong; Genant, Harry K; Eriksen, Erik F (2003). "Recombinant Human Parathyroid Hormone (1-34) [Teriparatide] Improves Both Cortical and Cancellous Bone Structure". Journal of Bone and Mineral Research. 18 (11): 1932–1941. doi: 10.1359/jbmr.2003.18.11.1932 . ISSN   0884-0431. PMID   14606504.
  5. 1 2 Flygare, Lennart; Hosoki, Hidehiko; Rohlin, Madeleine; Petersson, Arne (1997). "Bone Histomorphometry using interactive image analysis. A methodological study with application on the human temporomandibular joint". European Journal of Oral Sciences. 105 (1): 67–73. doi:10.1111/j.1600-0722.1997.tb00182.x. ISSN   0909-8836. PMID   9085031.
  6. 1 2 Lindsay, Robert; Zhou, Hua; Cosman, Felicia; Nieves, Jeri; Dempster, David W; Hodsman, Anthony B (2007). "Effects Of a One-Month Treatment With PTH(1-34) on Bone Formation on Cancellous, Endocortical, and Periosteal Surfaces of the Human Ilium". Journal of Bone and Mineral Research. 22 (4): 495–502. doi: 10.1359/jbmr.070104 . ISSN   0884-0431. PMID   17227219. S2CID   911699.
  7. 1 2 Dempster, David W.; Cosman, Felicia; Kurland, Etah S.; Zhou, Hua; Nieves, Jeri; Woelfert, Lillian; Shane, Elizabeth; Plavetić, Katarina; Müller, Ralph; Bilezikian, John; Lindsay, Robert (2001). "Effects of Daily Treatment with Parathyroid Hormone on Bone Microarchitecture and Turnover in Patients with Osteoporosis: A Paired Biopsy Study*". Journal of Bone and Mineral Research. 16 (10): 1846–1853. doi: 10.1359/jbmr.2001.16.10.1846 . ISSN   0884-0431. PMID   11585349.
  8. ↑ Revell, P A (1983). "Histomorphometry of bone". Journal of Clinical Pathology. 36 (12): 1323–1331. doi: 10.1136/jcp.36.12.1323 . ISSN   0021-9746. PMC   498562 . PMID   6361070.
  9. ↑ Leeuw, Jan A; Koudstaal, Jan; Wiersema-Buist, Janneke; Kamps, Willem A; Timens, Wim (2003). "Bone Histomorphometry in Children with Newly Diagnosed Acute Lymphoblastic Leukemia". Pediatric Research. 54 (6): 814–818. doi: 10.1203/01.pdr.0000090929.16450.de . ISSN   0031-3998. PMID   12930910.
  10. ↑ Serrano, S.; Mariñoso, M.L.; Soriano, J.C.; Rubiés-Prat, J.; Aubia, J.; Coll, J.; Bosch, J.; Del Rio, L.; Vila, J.; Goday, A.; Nacher, M. (1995). "Bone remodelling in human immunodeficiency virus-1-infected patients. A histomorphometric study". Bone. 16 (2): 185–191. doi:10.1016/8756-3282(94)00028-x. ISSN   8756-3282. PMID   7756046.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.