(BQ) Part 1 book “Pediatric bone biology & diseases” has contents: Pediatric bone histomorphometry, a diagnostic approach to skeletal dysplasias, the spectrum of pediatric osteoporosis, osteogenesis imperfecta, sclerosing bone dysplasias, and other contents. | C H A P T E R 16 Pediatric Bone Histomorphometry Frank Rauch Shriners Hospital for Children, Montreal, Quebec, Canada INTRODUCTION Bone biopsies can be useful for establishing a diagnosis in an individual patient with a bone disorder. They can also be used for investigating disease characteristics or treatment effects. Biopsy samples can be assessed qualitatively or quantitatively. The quantitative analysis of bone specimens is called bone histomorphometry. Bone histomorphometry is a key tool for studying bone tissue. Both the activity of bone metabolism and the amount and distribution of bone tissue can be analyzed with unsurpassed resolution. When tetracycline labeling is performed prior to biopsy, bone histomorphometry offers the unique possibility to study bone cell function in vivo. Importantly for pediatric use, the growth process does not directly interfere with the measurements. Bone histomorphometry is also an excellent educational tool. The insight derived from studying bone tissue can be used better to understand results of indirect methods, such as bone densitometry or biochemical markers of bone metabolism. Knowledge of bone tissue is crucial to put the disparate findings of molecular and cellular studies into perspective. Despite these advantages, bone histomorphometry is underused in pediatrics. This may be partly due to the fact that histomorphometry requires an invasive procedure to obtain a bone sample, is labor intensive, and needs special equipment and expertise. Other reasons may include overestimation of the utility of non-invasive bone diagnostics and lack of information about what bone histomorphometry does. Bone tissue is very hard and for that reason is more difficult to process than soft tissues. In routine pathology, bone tissue is therefore usually decalcified and thus converted into a soft tissue. However, this leads to the loss of important information about bone mineralization and bone cell activity. To assess metabolic Pediatric
