Histomorphometric Examination

Bone biopsy is indicated in case of a suspected metabolic disease of the bone (e.g. osteomalacia, renal osteodystrophy, accelerated bone resorption), spontaneous fractures or low-energy fractures and for investigating causes and effect of treatment of severe osteoporosis.

This examination enables investigation of bone formation, resorption and mineralization rate as well as microarchitecture of the cansellous bone.

In case of a suspected malignancy, histomorphometric examination of the bone is not sufficient. In these cases a separate sample should be taken for a pathological examination (PAD).

Biopsy can be performed during operations or as a outpatient procedure by using local anesthesia. Biopsy will be taken from the iliac bone by using either vertical or horizontal (transiliac) technique. Biopsy should be 5-7 mm in diameter and should be stored in 70-80 % alcohol. If possible, the biopsy should be preceded by in vivo tetracycline labeling, which provides valuable information about the speed of  bone synthesis and mineralization.

Samples must be delivered to:

University of Eastern Finland
Kuopio campus
SIB Labs
Ritva Savolainen
P.O. Box 1627
FI-70211 Kuopio
FINLAND

Bone Histomorphometry Publications

Laakso S, Xiaoyu T, Blouin S, Keplinger P, Välimäki VV, Kröger H, Mäkitie O, Hartmann MA. Bone Tissue Evaluation Indicates Abnormal Mineralization in Patients with Autoimmune Polyendocrine Syndrome Type I: Report on Three Cases. Calcif Tissue Int. 2023 Jun;112(6):675-682.

Keronen S, Martola L, Finne P, Burton IS, Tong XF, Kröger H, Honkanen E. Bone volume, mineral density, and fracture risk after kidney transplantation. PLoS One. 2022 Mar 29;17(3):e0261686

Tong X, Turunen MJ, Burton IS, Kröger H. Generalized Uncoupled Bone Remodeling Associated With Delayed Healing of Fatigue Fractures. JBMR Plus. 2022 Jan 19;6(3):e10598.

Aaltonen L, Koivuviita N, Seppänen M, Kröger H, Tong X, Löyttyniemi E, Metsärinne K. Association between bone mineral metabolism and vascular calcification in end-stage renal disease. BMC Nephrol. 2022 Jan 3;23(1):12.

Keronen SM, Martola LAL, Finne P, Burton IS, Tong XF, Kröger HP, Honkanen EO. Clinical Prediction of High-Turnover Bone Disease After Kidney Transplantation. Calcif Tissue Int. 2022 Mar;110(3):324-333.

Aaltonen L, Koivuviita N, Seppänen M, Burton IS, Kröger H, Löyttyniemi E, Metsärinne K. Bone Histomorphometry and 18F-Sodium Fluoride Positron Emission Tomography Imaging: Comparison Between only Bone Turnover-based and Unified TMV-based Classification of Renal Osteodystrophy. Calcif Tissue Int. 2021 Dec;109(6):605-614.

Aaltonen L, Koivuviita N, Seppänen M, Tong X, Kröger H, Löyttyniemi E, Metsärinne K. Correlation between (18)F-Sodium Fluoride positron emission tomography and bone histomorphometry in dialysis patients. Bone. 2020 May;134:115267.

Kröger L, Löppönen T, Ala-Kokko L, Kröger H, Jauhonen HM, Lehti K, Jääskeläinen J. A novel mutation in the matrix metallopeptidase 2 coding gene associated with intrafamilial variability of multicentric osteolysis, nodulosis, and arthropathy. Mol Genet Genomic Med. 2019 Aug;7(8):e802.

Keronen S, Martola L, Finne P, Burton IS, Kröger H, Honkanen E. Changes in Bone Histomorphometry after Kidney Transplantation. Clin J Am Soc Nephrol. 2019 Jun 7;14(6):894-903.

Power J, Loveridge N, Kröger H, Parker M, Reeve J. Femoral neck cortical bone in female and male hip fracture cases: Differential contrasts in cortical width and sub-periosteal porosity in 112 cases and controls. Bone. 2018 Sep;114:81-89.

Tong X, Malo MKH, Burton IS, Jurvelin JS, Isaksson H, Kröger H. Histomorphometric and osteocytic characteristics of cortical bone in male subtrochanteric femoral shaft. J Anat. 2017 Nov;231(5):708-717.

Tong X, Burton IS, Jurvelin JS, Isaksson H, Kröger H. Iliac crest histomorphometry and skeletal heterogeneity in men. Bone Rep. 2016 Nov 28;6:9-16.

Keronen S, Martola L, Finne P, Burton IS, Kauppila L, Kröger H, Larsson TE, Honkanen E. Bone histomorphometry and indicators of bone and mineral metabolism in wait-listed dialysis patients. Clin Nephrol. 2016 Mar;85(3):127-34.

Tong X, Burton IS, Isaksson H, Jurvelin JS, Kröger H. Cortical bone histomorphometry in male femoral neck: the investigation of age-association and regional differences. Calcif Tissue Int. 2015 Apr;96(4):295-306. doi: 10.1007/s00223-015-9957-9. Epub 2015 Feb 4. PMID: 25646589.

Laine CM, Wessman M, Toiviainen-Salo S, Kaunisto MA, Mäyränpää MK, Laine T, Pekkinen M, Kröger H, Välimäki VV, Välimäki MJ, Lehesjoki AE, Mäkitie O. A novel splice mutation in PLS3 causes X-linked early onset low-turnover osteoporosis. J Bone Miner Res. 2015 Mar;30(3):510-8.

Tong XY, Malo M, Tamminen IS, Isaksson H, Jurvelin JS, Kröger H. Development of new criteria for cortical bone histomorphometry in femoral neck: intra- and inter-observer reproducibility. J Bone Miner Metab. 2015 Jan;33(1):109-18.

Tamminen IS, Misof BM, Roschger P, Mäyränpää MK, Turunen MJ, Isaksson H, Kröger H, Mäkitie O, Klaushofer K. Increased heterogeneity of bone matrix mineralization in pediatric patients prone to fractures: a biopsy study. J Bone Miner Res. 2014;29(5):1110-7.

Tamminen IS, Yli-Kyyny T, Isaksson H, Turunen MJ, Tong X, Jurvelin JS, Kröger H. Incidence and bone biopsy findings of atypical femoral fractures. J Bone Miner Metab. 2013 Sep;31(5):585-94.

Laine CM, Joeng KS, Campeau PM, Kiviranta R, Tarkkonen K, Grover M, Lu JT, Pekkinen M, Wessman M, Heino TJ, Nieminen-Pihala V, Aronen M, Laine T, Kröger H, Cole WG, Lehesjoki AE, Nevarez L, Krakow D, Curry CJ, Cohn DH, Gibbs RA, Lee BH,  Mäkitie O. N.  WNT1 mutations in early-onset osteoporosis and osteogenesis imperfecta. Engl J Med. 2013 May 9;368(19):1809-16.

Tamminen IS, Mäyränpää MK, Turunen MJ, Isaksson H, Mäkitie O, Jurvelin JS, Kröger H. Altered bone composition in children with vertebral fracture. J Bone Miner Res. 2011 Sep;26(9):2226-34. doi: 10.1002/jbmr.409. Erratum in: J Bone Miner Res. 2013 Mar;28(3):709-10.

Mäyränpää MK, Tamminen IS, Kröger H, Mäkitie O. Bone biopsy findings and correlation with clinical, radiological, and biochemical parameters in children with fractures. J Bone Miner Res. 2011 Aug;26(8):1748-58.

Tamminen IS, Isaksson H, Aula AS, Honkanen E, Jurvelin JS, Kröger H. Reproducibility and agreement of micro-CT and histomorphometry in human trabecular bone with different metabolic status. J Bone Miner Metab. 2011 Jul;29(4):442-8.

Mäkitie O, Pereira RC, Kaitila I, Turan S, Bastepe M, Laine T, Kröger H, Cole WG, Jüppner H. Long-term clinical outcome and carrier phenotype in autosomal recessive hypophosphatemia caused by a novel DMP1 mutation. J Bone Miner Res. 2010 Oct;25(10):2165-74

Hiltunen MO, Ruuskanen M, Huuskonen J, Mähönen AJ, Ahonen M, Rutanen J, Kosma VM, Mahonen A, Kröger H, Ylä-Herttuala S. Adenovirus-mediated VEGF-A gene transfer induces bone formation in vivo. FASEB J. 2003 Jun;17(9):1147-9.

Arnala I, Kemppainen T, Kröger H, Janatuinen E, Alhava EM. Bone histomorphometry in celiac disease. Ann Chir Gynaecol. 2001;90(2):100-4. P

Panula HE, Nieminen J, Parkkinen JJ, Arnala I, Kröger H, Alhava E. Subchondral bone remodeling increases in early experimental osteoarthrosis in young beagle dogs. Acta Orthop Scand. 1998 Dec;69(6):627-32.

Kröger H, Soppi E, Loveridge N. Growth hormone, osteoblasts, and marrow adipocytes: a case report. Calcif Tissue Int. 1997 Jul;61(1):33-5.

Arnala I, Kyrölä K, Kröger H, Alhava EM. Analysis of 245 consecutive hip fracture patients with special reference to bone metabolism. Ann Chir Gynaecol.1997;86(4):343-7.

Kröger H, Arnala I, Rehnberg V, Hämäläinen M, Alhava E. Histomorphometry of periarticular bone in rheumatoid arthritis. Ann Chir Gynaecol. 1994;83(1):56-62.

Kröger H, Risteli J, Risteli L, Penttilä I, Alhava E. Serum osteocalcin and carboxyterminal propeptide of type I procollagen in rheumatoid arthritis. Ann Rheum Dis. 1993 May;52(5):338-42.

Kröger H, Arnala I, Alhava EM. Effect of calcitonin on bone histomorphometry and bone metabolism in rheumatoid arthritis. Calcif Tissue Int. 1992 Jan;50(1):11-3.