Bone histomorphometry, aluminum stain
What is this test?
This test measures the amount of aluminum in bone. It is used to diagnose and manage complications from too much aluminum. It is also used to detect aluminum bone diseases in patients on dialysis.
What are other names for this test?
What are related tests?
Why do I need this test?
Laboratory tests may be done for many reasons. Tests are performed for routine health screenings or if a disease or toxicity is suspected. Lab tests may be used to determine if a medical condition is improving or worsening. Lab tests may also be used to measure the success or failure of a medication or treatment plan. Lab tests may be ordered for professional or legal reasons. You may need this test if you have:
When and how often should I have this test?
When and how often laboratory tests are done may depend on many factors. The timing of laboratory tests may rely on the results or completion of other tests, procedures, or treatments. Lab tests may be performed immediately in an emergency, or tests may be delayed as a condition is treated or monitored. A test may be suggested or become necessary when certain signs or symptoms appear.
Due to changes in the way your body naturally functions through the course of a day, lab tests may need to be performed at a certain time of day. If you have prepared for a test by changing your food or fluid intake, lab tests may be timed in accordance with those changes. Timing of tests may be based on increased and decreased levels of medications, drugs or other substances in the body.
The age or gender of the person being tested may affect when and how often a lab test is required. Chronic or progressive conditions may need ongoing monitoring through the use of lab tests. Conditions that worsen and improve may also need frequent monitoring. Certain tests may be repeated to obtain a series of results, or tests may need to be repeated to confirm or disprove results. Timing and frequency of lab tests may vary if they are performed for professional or legal reasons.
How should I get ready for the test?
A bone biopsy is a procedure that requires written consent. Review the consent form with the healthcare worker and ask any questions that you have before signing the consent form. Tell the healthcare worker if you have a medical condition or are using a medication or supplement that causes excessive bleeding. You should also report if you have a history of allergic or other reactions to local anesthetics. Inform the healthcare worker of any past or present bone diseases. Generally, this procedure can be done with local anesthetic. However, an open bone biopsy is a surgical procedure that may require regional or general anesthesia. If you are having an open bone biopsy, follow the preparation instructions of the anesthesiologist and your surgeon.
How is the test done?
The person doing the bone biopsy will select one or more bones to biopsy. The method to be used and bone selected for the procedure may vary depending on the reason for the test and many other factors.
Regional or general anesthesia will be used if you are having an open biopsy. Your skin will be shaved and cleaned, and a sterile area will be prepared for the procedure. An incision will be made over or near the bone to be biopsied, instruments will be inserted into the incision, and the sample collected. Depending on the test results, surgery may be performed immediately, or the incision will be closed.
Before a drill biopsy, local anesthetic will be given. This medication makes the area numb. The biopsy needle will be pushed into the bone with the assistance of a special drill. The needle is rotated to collect a sample, and then the needle and sample are removed.
How will the test feel?
The amount of discomfort you feel will depend on many factors, including your sensitivity to pain. Communicate how you are feeling with the person doing the test. Inform the person doing the test if you feel that you cannot continue with the test.
During a drill needle bone biopsy, you will receive local anesthetic but may still feel pressure and discomfort when the biopsy needle enters the bone. After the biopsy, the area may be sore for several days. For an open bone biopsy, an anesthesiologist will give you a general or regional anesthetic. During general anesthesia, medicine will put you into a deep sleep where you are unable to feel pain. With regional anesthesia or a block, medicine will be given that numbs a nerve or group of nerves that supplies a certain area of your body. With a regional anesthetic, you are awake but will not feel pain or pressure in the numbed area. After an open bone biopsy, you may experience discomfort in the area for several days.
What should I do after the test?
After a bone biopsy, follow the instructions given to you by the healthcare worker regarding changing bandages and caring for the wound. Contact healthcare workers if you see increasing redness, swelling, or pus at the procedure site, or for increased pain or drainage from the area. Contact healthcare workers if you develop a fever, headache, or pain with movement.
What are the risks?
Bone: A bone sample is collected by a procedure called biopsy. Bone biopsy risks vary depending on the biopsy method used and the site selected for the biopsy. General risks of a bone biopsy include bleeding from the procedure site, bone fracture, damage to surrounding tissue, and bone infection. If you have a medical condition, or are using a medication or supplement that causes excessive bleeding, you are at a higher risk of bleeding from the procedure site. The person doing this procedure may need to perform it more than once. Talk to your healthcare worker if you have any concerns about the risks of having a bone biopsy.
What are normal results for this test?
Laboratory test results may vary depending on your age, gender, health history, the method used for the test, and many other factors. If your results are different from the results suggested below, this may not mean that you have a disease. Contact your healthcare worker if you have any questions. The following is considered to be a normal result for this test:
Bone aluminum level: 1 microgram/g wet weight 
What follow up should I do after this test?
Ask your healthcare worker how you will be informed of the test results. You may be asked to call for results, schedule an appointment to discuss results, or notified of results by mail. Follow up care varies depending on many factors related to your test. Sometimes there is no follow up after you have been notified of test results. At other times follow up may be suggested or necessary. Some examples of follow up care include changes to medication or treatment plans, referral to a specialist, more or less frequent monitoring, and additional tests or procedures. Talk with your healthcare worker about any concerns or questions you have regarding follow up care or instructions.
Where can I get more information?
 Fournier A, Oprisiu R, Hottelart C, et al: Renal osteodystrophy in dialysis patients: diagnosis and treatment.. Artif Organs 1998; 22:530-557.
 Hewitt CD, Savory J, & Wills MR: Aspects of aluminum toxicity. Clin Lab Med 1990; 10:403-422.
 D'Haese PC, Clement JP, Elseviers MM, et al: Value of serum aluminum monitoring in dialysis patients: a multicentre study. Nephrol Dial Transplant 1990; 5:45-53.
 Visser WJ & Van de Vyver FL: Aluminum-induced osteomalacia in severe chronic renal failure (SCRF). Clin Nephrol 1985; 24 Suppl 1:S30-S36.
 Teitelbaum SL: Renal osteodystrophy. Hum Pathol 1984; 15(4):306-23.
Last Updated: 6/13/2013
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