The transiliac bone biopsy: When to get it and how to interpret it

Although the accurate diagnosis of most metabolic bone diseases is possible with noninvasive studies, a transiliac bone biopsy can provide information about rates of bone turnover and mineralization that cannot be obtained by any other means. On occasion, it is necessary to integrate the histologie findings with the clinical presentation to establish a diagnosis and/or initiate appropriate therapy. This short review will attempt to provide the practicing endocrinologist with an understanding of tech’ niques of a bone biopsy, the special tools employed by the histopathologist to prepare and examine the biopsy specimen, the relevant information that can be derived from a bone section, and, most importantly, the usefulness of this information in the diagnosis and management of metabolic bone disorders.