In This Section      

Protocol for Sending Muscle Biopsy Specimens

  1. Please notify the Neuromuscular Pathology Laboratory two days in advance that a muscle specimen will be arriving.  Please contact:
  2. A surgeon familiar with the diagnostic muscle biopsy procedure should obtain the specimen. Three strips of muscle approximately 2.5 cm x 0.5 cm parallel to the direction of the muscle fibers should be obtained. A muscle that is moderately but not severely weak should be used for the biopsy (4/5 on the British Medical Research Council Scale).
  3. It is preferable that the specimen be delivered fresh within one hour after excision. If this is possible, wrap the muscle in a piece of saline-moistened gauze and place it in a container or plastic bag. DO NOT IMMERSE BIOPSY SAMPLES IN SALINE. Place in a styrofoam container with regular ice and send immediately by special messenger to:

    Neuromuscular Pathology Laboratory
    Johns Hopkins Hospital
    600 N. Wolfe Street
    Meyer Building Room 5-119
    Baltimore, MD 21287-7519
    Phone: 410-614-4163

    Please notify us when to expect the specimen.
  4. If the specimen cannot be delivered in one hour, then it must be frozen immediately after excision, as follows:
    • Pour 2-methylbutane (isopentane) into a metal container that will hold a minimum of 200 ml.
    • Drop small pieces of dry ice into the liquid to cool it.
    • Surround the container with dry ice to keep it cold.

    Immediately after excision, the muscle specimen should be stretched in the direction of the fibers to just beyond its in situ resting length, and pinned at each end to a small piece of stiff card (index card). Hold the piece of cardboard with the pinned muscle using a Kelly clamp or pair of forceps, and quickly immerse it in the cold liquid, vigorously shaking the card for 15-20 seconds. This technique disperses bubbles that form around the specimen which would otherwise prevent uniform freezing. When it is thoroughly frozen, pack the specimen in sufficient dry ice and ship overnight to:

    Christopher Dorsey
    The Neuromuscular Pathology Laboratory
    Johns Hopkins Hospital
    600 N. Wolfe Street
    Meyer Building Room 5-119
    Baltimore, MD 21287-7519
    Phone: 410-608-3902
  5. The following information will be needed.  Tissue samples cannot be processed unless this information is provided with the specimen.
    • Patient's name, address, date of birth, and hospital ID number
    • Hospital charge number for billing directly to the hospital
    • Brief clinical history
    • Identification of muscle biopsy site, date, and time
    • Name, address, phone and fax # of referring pathologist and attending physicians

    Electron microscopy of muscle is not routinely done but rarely indicated. If electron microscopy is requested, please contact Dr. Thomas E. Lloyd or Dr. Ahmet Hoke at 410-955-2227 before the biopsy is done as the tissue must be fixed in a special fixative at the time of the biopsy.

Request an Appointment

Maryland Patients

Adult Neurology: 410-955-9441
Pediatric Neurology: 410-955-4259

Adult Neurosurgery: 410-955-6406
Pediatric Neurosurgery: 410-955-7337


Traveling for Care?

Whether you're crossing the country or the globe, we make it easy to access world-class care at Johns Hopkins.

Outside of Maryland (toll free)

Request an Appointment
Medical Concierge Services

International Patients

Request an Appointment
Medical Concierge Services

blue suitcase