Recommendations for the biopsy procedure and assessment of skeletal muscle biopsies

Muscle biopsy has a valuable diagnostic role in many neuromuscular diseases, but it is an invasive investigation that should not be undertaken lightly. Furthermore, the biopsy procedure and subsequent laboratory processing of the specimen may significantly influence the results. The following guide is designed to optimise the diagnostic information that can be obtained from muscle biopsy. It covers the whole procedure, from selection of the biopsy site and technique of biopsy, progressing through freezing of the specimen for histochemistry, and the role of immunocytochemistry and electron microscopy. Finally, the contents of a model biopsy report are considered.