Bone biopsy and histomorphometry as a tool for diagnosis of osteoporosis and other metabolic bone diseases

Osteoporoza je sistemska bolest skeleta karakterizirana redukcijom koštane mase i poremećajem unutrašnje arhitekture koštanog tkiva, što dovodi do povećane fragilnosti kostiju i sklonosti prijelomima. Prema WHO, glavni dijagnostički kriterij za osteoporozu je BMD za lumbalni dio kralježnice i femur više od 2,5 SD ispod normalne vrijednosti koštane mase referentne za određenu starosnu dob. Statistički izvještaji govore da je danas u Hrvatskoj oko 250.000 žena oboljelo od osteoporoze. Prema službenim smjernicama za dijagnostiku, prevenciju i liječenje osteoporoze u RH, u dijagnostici osteoporoze, pored denzitometrije, rendgenograma torako-lumbalne kralježnice te laboratorijskih pokazatelja pregradnje kosti, preporučuje se i biopsija kosti s histomorfometrijom. Cilj je ovog rada uputiti na metodu koštane biopsije i histomorfometrije i njenu vrijednost u dijagnostici, ali i praćenju liječenja metaboličkih bolesti kostiju i osteoporoze.Osteoporosis is systemic skeletal disease characterised by reduction of bone mass as well as disruption of internal architecture of the osseous tissue which leads to increased bone fragility and tendency for fracture. According to WHO the primary diagnostic criteria for osteoporosis is BMD more than 2,5 SD below normal values of bone mass referral for certain age, measured on lumbar spine and femoral bone. Over 250.000 women are diagnosed with osteoporosis in Croatia. According to guidance for osteoporosis diagnosis, prevention and treatment, except for bone densitometry, X-rays of thoraco-lumbar spine and biochemical markers of bone remodeling, bone biopsy and histomorphometry are suggested. The aim of this paper is to describe bone biopsy and histomorphometry as a valuable method for diagnostics and follow up in metabolic bone diseases and osteoporosis