Bone Histomorphometry Laboratory

Transiliac Crest Core Bone Biopsy

The ideal sample for a histomorphometric analysis of bone is a horizontal transiliac crest core biopsy. This is a relatively simple and painless procedure which may be performed in an outpatient clinic. Complications are minimal. The patient will be required to spend only a morning in the clinic. Patients are typically double-labeled with tetracycline prior to the biopsy to allow for calculation of kinetic indices of bone turnover.

bone biopsy

A manual trochar with an internal diameter of 7-8 mm should be used to obtain a 6-7 mm core biopsy. Manual trochars are preferred to electric drills because there is less tissue damage and artifact.

If a core biopsy cannot be obtained, a histomorphometric analysis can be performed on a Jamshidi needle bone biopsy specimen. In addition, bone from any location may be used for analysis. If, for example, a patient is scheduled for a surgical procedure and it is more convenient to obtain a bone sample at this time, this bone may be sent for analysis. However, these types of samples are less than optimal.

Once obtained, the sample should be placed in room temperature 70% ethanol and mailed, with a completed biopsy request form, to:
Edward F. McCarthy, M.D.
The Johns Hopkins Hospital
Department of Pathology
Weinberg Bldg., Room 2261
401 North Broadway
Baltimore, MD 21231-2410

Phone: (410) 614-3653
Fax: (410) 614-3766

The Johns Hopkins Bone Histomorphometry Laboratory is a full service lab that specializes in the processing and evaluation of undecalcified bone biopsies for proven or suspected metabolic bone disease. It is directed by Edward McCarthy, M.D., Associate Professor of Pathology and Orthopaedic Surgery at The Johns Hopkins School of Medicine.