Velásquez FFH

Language: Spanish
References: 37
Page: 108-117
PDF size: 468.08 Kb.

ABSTRACT

The histomorphometric bone biopsy study obtained previous double tetracycline labeled, today is the “golden key” for the study of the mineral metabolic bone diseases. The transiliac bone biopsy is a safe proceeding. In the biopsy we analyzed the modeling and remodeling bone activity, both processes are performed by the same cells, but differ in the way that they are arranged. The main effect of modeling is to lead to changes in bone shape size and mass, whereas remodeling is to renew bone due to the few data on the modeling process, the following discussion will be focuses on remodeling. The bone remodeling is located mainly in the trabecular bone through a basic multicellular unit (BRU), which its main action consists of successive cycles of bone resorption and formation on the same trabecular surface. The BRU number is constant, its activity is asynchronous, the amount of bone removed is replaced (remodeling balance), the mineralizing surface is homogeneous and its individual time activity is constant. Any alteration of these qualities, leading to metabolic bone disease. Example: If the BRU increased in number, if their time of activity shortens and their mineralization surface increases, it means that there is a high remodeling bone disease. On the other hand, if the number of BRU diminished, if its time of activity enlarges and if its mineralizing surface is scanty, it showes the image of a low remodeling bone disease. The histomorphometric parameters are classified as structural parameters (amount of bone and size), resorption parameters (percentage osteoclasts, eroded surface and peritrabecular fibrosis), static formation parameters (percentage osteoblast, osteoid surface and osteoid thickness) and dynamic bone formation parameters, that show information about in vivo bone cell function (mineralizing surface, mineral apposition rate and others derived from these primary measures). We must take into account that the remodeling activity changes markedly with aging. We had few information about the metals bone levels; the bone biopsy allows us to know biochemical metals levels. Metabolic bone biopsy is indicated to establish specific diagnosis to prescribe treatments and some times to dilucidate prognosis. It is recommended to performed bone metabolic biopsy in renal osteodystrophies, osteogenesis imperfecta, idiopathic juvenile osteoporosis, polyostotic fibrous dysplasia, vitamin D dependent rickets, hypophosphatemic syndromes, chronic gastrointestinal conditions with bone disease, biliary atresia, primary hyperparathyroidism, pathological fractures, before any organ transplantation, in therapeutic protocols and toxicity or depletion of trace elements.

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