Test ID: BHIS
Bone Histomorphometry, Quantitative
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) for each procedure performed will be forwarded at no additional charge. See BHALU/9614 Bone Histomorphometry, Aluminum Stain. In addition to the above procedure (BHIS/9034 Bone Histomorphometry, Quantitative), BHAP/5561 Bone Histomorphometry, Acid Phosphatase Stain and BHIRO/9794 Bone Histomorphometry, Iron Stain are available at an additional charge. Duplicate stained slides (BHDS/83166 Bone Histomorphometry, Duplicate Slides) are available upon request at an additional charge.
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Aluminum (Al) Stain
Bone Histomorphometry (always order 9034 quantitative)
Hitomorphometry, Bone
Toluidine Blue
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
Preferred: Anterior iliac crest
Container/Tube: Metal-free container (Supply T173)
Specimen Volume: Entire specimen
Collection Instructions:
1. Fix specimen in 70% ethanol.
2. Quantitation of bone turnover requires 2 time-spaced tetracycline labels.
Additional Information:
1. Consultation with a Mayo Medical Laboratories pathologist or endocrinologist/nephrologist is recommended for first-time users of this service. Written instructions are available upon request.
2. For further information, see Bone Histomorphometry Fact Sheet (Supply T579) 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 | Anticoagulants other than 70% alcohol |
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 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. Other information obtainable relates 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 a quantitative and 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
Computer-generated histomorphometric values are given.
Normal histomorphometric values for iliac crest are provided (female only).
An interpretive report is provided.
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.
It is preferred that the specimen is shipped in 70% ethanol because it preserves the tetracycline label in the bone.
Biopsy site of preference is iliac crest.
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 micron thickness, and individual sections are stained with Goldner's Trichrome, toluidine blue, 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 1 of 7 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 1986;61:28-33)
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.
88313-Bone histomorphometry, quantitative
88323-Consultative report on referred material and slides
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 |
|---|---|---|
| BHIS | Bone Histomorphometry, QN | N/A |
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