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HelpTest Code BHISC Bone Histomorphometry, Gross Microscopic Exam
Shipping Instructions
It is preferred that the specimen is shipped in 70% ethanol because it preserves the tetracycline label in the bone.
Necessary Information
Bone Histomorphometry: Patient Information (T352) must be completed and sent with the specimen. The laboratory requires this information in order to perform testing.
Specimen Required
Supplies: Metal Free Specimen Vial (T173)
Specimen Type: Bone
Preferred: Anterior iliac crest
Container/Tube: Metal-free specimen vial
Specimen Volume: Entire specimen
Collection Instructions:
1. Fix specimen in 70% ethanol.
2. Quantitation of bone turnover requires 2 time-spaced tetracycline labels.
3. The use of metal-free containers is required to avoid aluminum or iron contamination.
4. For complete instructions see Bone Histomorphometry Specimen Preparation (T579).
Additional Information: Consultation with a Mayo Clinic Laboratories pathologist or endocrinologist/nephrologist is recommended for first-time users of this service. Written instructions are available upon request.
Forms
Secondary ID
70312Useful For
Undetermined metabolic bone disease in wet tissue specimens
Renal osteodystrophy
Osteomalacia
Osteoporosis
Paget disease
Assessing effects of therapy
Identification of some disorders of the hematopoietic system
Aluminum toxicity
Presence of iron in the bone
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| SS2PC | SpecStain, Grp II, other | No, (Bill Only) | No |
Testing Algorithm
Hematoxylin and eosin-stained slides are sent to pathology for review. Iron staining or aluminum staining may be performed at an additional charge.
Special Instructions
Method Name
Histomorphometry
Reporting Name
Bone HistoMorph Gross Micro ExamSpecimen Type
VariesSpecimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient (preferred) | ||
| Refrigerated | |||
Reject Due To
| Fixatives other than 70% alcohol Decalcified bone |
Reject |
Clinical Information
Bone histomorphometry is a very sophisticated procedure utilizing full-thickness bone biopsy.
Techniques such as 2-time interval labeling with tetracycline permit the direct measurement of the rate of bone formation. The information derived is useful in the diagnosis of metabolic bone diseases, including renal osteodystrophy, osteomalacia, and osteoporosis, and other disorders, such as aluminum toxicity and iron abnormalities.
Reference Values
A quantitative and interpretive report will be provided.
Interpretation
Computer-generated histomorphometric values are given for adequate specimens.
Normal histomorphometric values for iliac crest are provided.
An interpretive report will be provided.
Cautions
Mineralization or bone formation rates can be done only when tetracycline has been administered on a specific schedule prior to biopsy.
Biopsy site of preference is iliac crest.
Dairy products should not be ingested at the same time as the tetracycline because they interfere with tetracycline uptake.
Clinical Reference
1. Recker RR. Bone Histomorphometry: Techniques and Interpretation. CRC Press; 1983
2. Dempster DW, Compston JE, Drezner MK, et al. Standardized nomenclature, symbols, and units for bone histomorphometry: a 2012 update of the report of the ASBMR Histomorphometry Nomenclature Committee. J Bone Miner Res. 2013;28(1):2-17. doi:10.1002/jbmr.1805
3. Chavassieux P, Chapurlat R. Interest of bone histomorphometry in bone pathophysiology investigation: Foundation, present, and future. Front Endocrinol (Lausanne). 2022;13:907914. Published 2022 Jul 28. doi:10.3389/fendo.2022.907914
Method Description
Intact (nonfragmented) specimens of undecalcified bone are dehydrated in ethanol, embedded in methylmethacrylate, sectioned at 5-micron thickness, and individual sections are stained with Goldner Trichrome, toluidine blue, and hematoxylin and eosin. Special stains for acid phosphatase, aluminum, and iron are performed when indicated. Histomorphometry, by computerized technique, is then done on the stained sections using light microscopy and on unstained sections using fluorescence microscopy. Histomorphometric values and the histologic appearance of all sections are reviewed and interpreted by a clinician-histomorphometrist. A hematoxylin and eosin-stained section is reviewed for abnormalities by a pathologist. Telephone consultations with responsible physicians are carried out whenever possible.(Hodgson SF, Johnson KA, Muhs JM, Lufkin EG, McCarthy JT. Outpatient percutaneous biopsy of the iliac crest: methods, morbidity, and patient acceptance. Mayo Clin Proc. 1986;61[1]:28-33)
Day(s) Performed
Monday through Friday
Report Available
26 to 35 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
88346
88307
88313
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| BHISC | Bone HistoMorph Gross Micro Exam | 60570-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 71158 | Interpretation | 59465-5 |
| 71159 | Bone Marrow Interpretation | 51628-6 |
| 71160 | Participated in the Interpretation | No LOINC Needed |
| 71161 | Report electronically signed by | 19139-5 |
| 71162 | Material Received | 22633-2 |
| 71786 | Case Number | 80398-1 |
| 601908 | Disclaimer | 62364-5 |
Specimen Minimum Volume
5 mm bone