Test Id : BHISC
Bone Histomorphometry, Gross Microscopic Exam
Useful For
Suggests clinical disorders or settings where the test may be helpful
Undetermined metabolic bone disease in wet tissue specimens
Renal osteodystrophy
Osteomalacia
Osteoporosis
Paget disease
Assessing effects of therapy
Identification of some disorders of the hematopoietic system
Aluminum toxicity
Presence of iron in the bone
Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| SS2PC | SpecStain, Grp II, other | No, (Bill Only) | No |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Hematoxylin and eosin-stained slides are sent to pathology for review. Iron staining or aluminum staining may be performed at an additional charge.
Method Name
A short description of the method used to perform the test
Histomorphometry
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Al (Aluminum) Stain
Aluminum (Al) Stain
Histomorphometry, Bone
Toluidine Blue
Bone Histomorphometry
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Hematoxylin and eosin-stained slides are sent to pathology for review. Iron staining or aluminum staining may be performed at an additional charge.
Specimen Type
Describes the specimen type validated for testing
Varies
Shipping Instructions
It is preferred that the specimen is shipped in 70% ethanol because it preserves the tetracycline label in the bone.
Necessary Information
Bone Histomorphometry: Patient Information (T352) must be completed and sent with the specimen. The laboratory requires this information in order to perform testing.
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Supplies: Metal Free Specimen Vial (T173)
Specimen Type: Bone
Preferred: Anterior iliac crest
Container/Tube: Metal-free specimen vial
Specimen Volume: Entire specimen
Collection Instructions:
1. Fix specimen in 70% ethanol.
2. Quantitation of bone turnover requires 2 time-spaced tetracycline labels.
3. The use of metal-free containers is required to avoid aluminum or iron contamination.
4. For complete instructions see Bone Histomorphometry Specimen Preparation (T579).
Additional Information: Consultation with a Mayo Clinic Laboratories pathologist or endocrinologist/nephrologist is recommended for first-time users of this service. Written instructions are available upon request.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Forms
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
5 mm bone
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Fixatives other than 70% alcohol Decalcified bone | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient (preferred) | ||
| Refrigerated | |||
Useful For
Suggests clinical disorders or settings where the test may be helpful
Undetermined metabolic bone disease in wet tissue specimens
Renal osteodystrophy
Osteomalacia
Osteoporosis
Paget disease
Assessing effects of therapy
Identification of some disorders of the hematopoietic system
Aluminum toxicity
Presence of iron in the bone
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Hematoxylin and eosin-stained slides are sent to pathology for review. Iron staining or aluminum staining may be performed at an additional charge.
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, and other 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.
A quantitative and interpretive report will be provided.
Interpretation
Provides information to assist in interpretation of the test results
Computer-generated histomorphometric values are given for adequate specimens.
Normal histomorphometric values for iliac crest are provided.
An interpretive report will be provided.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Mineralization or bone formation rates can be done only when tetracycline has been administered on a specific schedule prior to biopsy.
Biopsy site of preference is iliac crest.
Dairy products should not be ingested at the same time as the tetracycline because they interfere with tetracycline uptake.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Recker RR. Bone Histomorphometry: Techniques and Interpretation. CRC Press; 1983
2. Dempster DW, Compston JE, Drezner MK, et al. Standardized nomenclature, symbols, and units for bone histomorphometry: a 2012 update of the report of the ASBMR Histomorphometry Nomenclature Committee. J Bone Miner Res. 2013;28(1):2-17. doi:10.1002/jbmr.1805
3. Chavassieux P, Chapurlat R. Interest of bone histomorphometry in bone pathophysiology investigation: Foundation, present, and future. Front Endocrinol (Lausanne). 2022;13:907914. Published 2022 Jul 28. doi:10.3389/fendo.2022.907914
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, sectioned at 5-micron thickness, and individual sections are stained with Goldner Trichrome, toluidine blue, and 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 a clinician-histomorphometrist. 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, Lufkin EG, McCarthy JT. Outpatient percutaneous biopsy of the iliac crest: methods, morbidity, and patient acceptance. Mayo Clin Proc. 1986;61[1]:28-33)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Friday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
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 Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
88346
88307
88313
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| BHISC | Bone HistoMorph Gross Micro Exam | 60570-9 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 71158 | Interpretation | 59465-5 |
| 71159 | Bone Marrow Interpretation | 51628-6 |
| 71160 | Participated in the Interpretation | No LOINC Needed |
| 71161 | Report electronically signed by | 19139-5 |
| 71162 | Material Received | 22633-2 |
| 71786 | Case Number | 80398-1 |
| 601908 | Disclaimer | 62364-5 |