The Bone Biopsy

Abstract

Most biopsy procedures suffer from two disadvantages; the first is that they are invasive, with the possible consequences of pain, bleeding, and infection, while the second concerns the question of how representative the specimen is of the whole tissue. Both difficulties can be partially overcome; the first by the use of a careful surgical procedure in which the muscle is cut as little as possible, while the infection and bleeding are controlled by antibiotics and packing or hemostasis if necessary. The question of variation from site to site in the body can be answered in two ways; the first is to assume that in metabolic and systemic diseases all parts of the tissue will be affected, if not equally at least proportionally, while the other approach is to sample a reasonable number of different parts of the tissue to ascertain the correctness of the assumption. Since the majority of tissues are made up of component parts that differ in both structure and function (i.e., the kidney is made up of cortex and medulla, while bone can be separated into trabecular or spongy bone and cortical or compact bone) it is necessary to sample all component parts in the proportion in which they occur in the body to obtain a representative sample of the organ. Although it is obvious, of course, that if only part of the tissue is of interest, then only that part needs to be sampled.