Synopsis
Muscle biopsy is a commonly ordered diagnostic procedure, used by clinicians who evaluate patients with weakness suspected to be caused by muscle disease. This article reviews the indications for a muscle biopsy, and then serves as a step-by-step guide reviewing the processes of muscle selection through to interpreting the biopsy report. The goal of this article is to aid the clinician in preparing for a muscle biopsy procedure so that they may avoid common pitfalls and obtain optimal results from this minimally invasive procedure. We review the basic anatomical structure of normal muscle to provide a foundation for understanding common patterns of pathologic change observed in muscle disease, and then present both common and disease-specific histopathologic findings, focused for illustrative purposes on a select group of neuromuscular diseases.