Iliac crest biopsy in the diagnosis of metabolic bone disease. A method study.

The Burkhardt instrument is a useful tool for obtaining bone biopsies from the iliac crest in order to study bone tissue. Information on bone mass, however, is rather unreliable and iliac crest biopsy has also a low predictive value for spinal bone mass, whereas estimation of osteoid is more useful and this variable cannot be studied by any other means. Even if the precision is only 20% or even less, the differences between patients are considerable and useful information can therefore be obtained. It was demonstrated in an unselected group of patients that, even if the number of cases which could be classified as osteomalacia was small, there were significant deviations in the amount of osteoid in many groups.