[Indications and prerequisites for bone biopsy]

The iliac crest biopsy provides additional information for the therapeutic approach in selected questions if the indication is correct. Indications include osteoporosis with an atypical course with respect to age, fracture frequency or success of therapy. The aim of the iliac crest biopsy is to harvest an undestroyed and intact piece of bone, containing all compartments, including cancellous bone, cortical bone and bone marrow. Knowledge of clinical and paraclinical parameters is essential for diagnosis and assessment. A safe sampling technique under sterile conditions must be guaranteed. The biopsy itself takes place in the anterior superior iliac spine and posterior superior iliac spine, preferably by using a Burkhardt or a diamond burr. Hard cutting technique and knowledge or the histomorphometry are indispensable prerequisites.