PMID- 37811524
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231030
IS  - 2352-1872 (Print)
IS  - 2352-1872 (Electronic)
IS  - 2352-1872 (Linking)
VI  - 19
DP  - 2023 Dec
TI  - Utility of iliac crest tetracycline-labelled bone biopsy in osteoporosis and 
      metabolic bone disease: An evaluation of 95 cases over a period of 25 years.
PG  - 101715
LID - 10.1016/j.bonr.2023.101715 [doi]
LID - 101715
AB  - BACKGROUND: Metabolic bone diseases (MBD) are typically diagnosed by non-invasive 
      imaging and clinical biomarkers. However, imaging does not provide structural 
      information, and biomarkers can be transiently affected by many systemic factors. 
      Bone biopsy and pathologic evaluation is the gold standard for diagnosis of MBD, 
      however, it is rarely utilized. We describe our technique for iliac crest 
      tetracycline-labelled bone using a cannulated drill and assess the utility of 
      bone biopsies to provide diagnostic and therapeutic guidance. METHODS: In the 
      25-year period between March 1998 and January 2023, a total of 95 bone biopsies 
      were performed on 94 patients for an osteological indication at Vanderbilt 
      University Medical Center (VUMC). Patient demographics, bone biopsy indications, 
      complications, diagnostic utility, and subsequent therapeutic guidance were 
      retrospectively reviewed and analyzed. RESULTS: The procedure had minimal 
      complications and was well tolerated by patients. This technique provided good 
      quality specimens for pathology, which helped establish a diagnosis and treatment 
      change in most patients. Patients that had biopsy-guided treatment alterations 
      showed significant increases in Dual-Energy X-ray Absorptiometry (DEXA) bone 
      mineral density (BMD) scores post-biopsy and subsequent treatment. CONCLUSION: 
      Despite scientific and technological progress in non-invasive diagnostic imaging, 
      clinical biomarkers, and procedures for MBD, there remains a small but 
      significant subset of patients who may benefit from inclusion of 
      tetracycline-labelled bone biopsy into the diagnostic and therapeutic picture. 
      Future prospective comparison studies are warranted. MINI ABSTRACT: 
      Tetracycline-labelled bone biopsies are under-utilized. Biopsy led to a 
      histological diagnosis and ensuing treatment alteration in most patients with 
      significant increases in bone mineral density. The biopsy procedure used herein 
      provided good specimens with low pain/adverse events. Bone biopsy remains a 
      valuable tool in a small, though significant, subset of patients.
CI  - (c) 2023 The Authors.
FAU - Colazo, Juan M
AU  - Colazo JM
AD  - Medical Scientist Training Program, Vanderbilt University School of Medicine, 
      Nashville, TN, USA.
FAU - Quirion, Julia
AU  - Quirion J
AD  - Division of Musculoskeletal Oncology, Department of Orthopaedic Surgery, 
      Vanderbilt University Medical Center, Nashville, TN, USA.
FAU - Judice, Anthony D
AU  - Judice AD
AD  - Division of Musculoskeletal Oncology, Department of Orthopaedic Surgery, 
      Vanderbilt University Medical Center, Nashville, TN, USA.
FAU - Halpern, Jennifer
AU  - Halpern J
AD  - Division of Musculoskeletal Oncology, Department of Orthopaedic Surgery, 
      Vanderbilt University Medical Center, Nashville, TN, USA.
FAU - Schwartz, Herbert S
AU  - Schwartz HS
AD  - Division of Musculoskeletal Oncology, Department of Orthopaedic Surgery, 
      Vanderbilt University Medical Center, Nashville, TN, USA.
FAU - Tanner, S Bobo
AU  - Tanner SB
AD  - Department of Medicine, Division of Rheumatology and Immunology, Vanderbilt 
      University Medical Center, Nashville, TN, USA.
FAU - Lawrenz, Joshua M
AU  - Lawrenz JM
AD  - Division of Musculoskeletal Oncology, Department of Orthopaedic Surgery, 
      Vanderbilt University Medical Center, Nashville, TN, USA.
FAU - Dahir, Kathryn M
AU  - Dahir KM
AD  - Department of Medicine, Division of Endocrinology and Diabetes, Vanderbilt 
      University Medical Center, Nashville, TN, USA.
FAU - Holt, Ginger E
AU  - Holt GE
AD  - Division of Musculoskeletal Oncology, Department of Orthopaedic Surgery, 
      Vanderbilt University Medical Center, Nashville, TN, USA.
LA  - eng
PT  - Journal Article
DEP - 20230924
PL  - United States
TA  - Bone Rep
JT  - Bone reports
JID - 101646176
PMC - PMC10558706
OTO - NOTNLM
OT  - Antibiotic-labelled bone biopsy
OT  - Bone biopsy
OT  - Metabolic bone disease
OT  - Osteomalacia
OT  - Osteoporosis
OT  - Tetracycline labelling
COIS- Juan M. Colazo, Julia Quirion, Anthony D. Judice, Jennifer Halpern, Herbert S. 
      Schwartz, S. Bobo Tanner, Kathryn M. Dahir, Joshua M. Lawrenz, and Ginger E. Holt 
      declare that they have no conflict of interest.
EDAT- 2023/10/09 12:42
MHDA- 2023/10/09 12:43
PMCR- 2023/09/24
CRDT- 2023/10/09 06:18
PHST- 2023/05/23 00:00 [received]
PHST- 2023/09/17 00:00 [revised]
PHST- 2023/09/22 00:00 [accepted]
PHST- 2023/10/09 12:43 [medline]
PHST- 2023/10/09 12:42 [pubmed]
PHST- 2023/10/09 06:18 [entrez]
PHST- 2023/09/24 00:00 [pmc-release]
AID - S2352-1872(23)00063-3 [pii]
AID - 101715 [pii]
AID - 10.1016/j.bonr.2023.101715 [doi]
PST - epublish
SO  - Bone Rep. 2023 Sep 24;19:101715. doi: 10.1016/j.bonr.2023.101715. eCollection 
      2023 Dec.