Test ID: BHINT
Bone Histomorphometry, Consultant Interpretation Only
NY State Approved 
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Undetermined metabolic bone disease
Renal osteodystrophy
Osteomalacia
Osteoporosis
Paget's disease
Assessing effects of therapy
Identification of some disorders of the hematopoietic system
Aluminum toxicity
Presence of iron in the bone
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Method Name A short description of the method used to perform the test
A specimen slide(s) will be forwarded at no additional charge.
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Specimen Type: Bone of preference is anterior iliac crest
Container/Tube: Metal-free container (Supply T173)
Collection Instructions:
1. Fix specimen in 70% ethanol.
2. Quantitation of bone turnover requires 2 time-spaced tetracycline labels.
3. Consultation with a Mayo Medical Laboratories pathologist or endocrinologist/nephrologist is recommended for first-time users of this service.
4. Written instructions are available upon request.
Additional Information: For further information, see Bone Histomorphometry Fact Sheet (Supply T579) in Bone Histomorphometry in Special Instructions.
Forms: Bone Histomorphometry Information Sheet (Supply T352) in Special Instructions
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Ambient | |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Bone histomorphometry is a very sophisticated procedure utilizing full thickness bone biopsy.
Techniques such as two-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. Other information obtainable relate to disorders such as aluminum toxicity and iron abnormalities.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
The laboratory will provide an interpretive report.
All results will be called to the physician designated on the Bone Histomorphometry Information Sheet.
Interpretation Provides information to assist in interpretation of the test results
Clinical endocrinologists trained in histomorphometric techniques review and interpret the histological appearance.
A pathologist interprets the bone marrow from an H & E stained slide.
No histomorphometric values are given.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Decalcified bone is not acceptable for histomorphometric analysis.
Mineralization or bone formation rates can be done only when tetracycline has been administered on a specific schedule prior to biopsy.
Containers should not be contaminated with aluminum or iron.
Shipping vehicle of preference is 70% ethanol because it preserves the tetracycline label in the bone.
Biopsy site of preference is iliac crest.
This test is used only if the specimen is inadequate.
Determination of an inadequate specimen can be made only upon microscopic investigation of the stained sections.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
Recker RR: Bone Histomorphometry: Techniques and Interpretation. Boca Raton,FL, CRC Press, 1983
Method Description Describes how the test is performed and provides a method-specific reference
Intact (nonfragmented) specimens of undecalcified bone are dehydrated in ethanol, embedded in methylmethacrylate (cold polymerization), sectioned at 5-10 micron thickness, and individual sections are stained with Goldner's Trichrome, solochrome, hematoxylin and eosin. Special stains for acid phosphatase, aluminum and iron are obtained 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 one of 4 clinician-histomorphometrists. 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, et al: Outpatient percutaneous biopsy of the iliac crest: methods, morbidity, and patient acceptance. Mayo Clin Proc 61:28-33, 1986)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday; 8 a.m. - 5 p.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Performing Laboratory Location The location of the laboratory that performs the test
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
88323
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| BHINT | Bone Histomorphometry Interp Only | N/A |
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