Percutaneous Musculoskeletal Needle Biopsy (Bone or Soft tissue Lesion Biopsy through the Skin)

A biopsy is a procedure performed to remove tissue or cells from the body for examination under a microscope. Percutaneous (through the skin), image-guided musculoskeletal biopsies provide an accurate, rapid, and cost-effective method for helping clinicians diagnose benign and malignant musculoskeletal lesions. Various imaging modalities can be used to target the lesion, including computed tomography (CT) scanning, fluoroscopy, ultrasound (US) scanning, and magnetic resonance imaging (MRI). This is a minimally invasive, but generally pretty accurate procedure. The diagnosis from a tiny sample will ultimately be the same as that from a large surgically obtained specimen. However, there is no guarantee that the pathologist will be able to make a diagnosis from the specimen.

• Determine if a lesion is malignant (cancerous) or benign
• Detemine the cause of an unexplained infection or inflammation

There may be other reasons for your physician to recommend a bone biopsy.

As with any surgical procedure, complications can occur. Reported incidence of complications ranges from 0-10%. Some possible complications may include, but are not limited to, the following:

• Bruising and discomfort at the biopsy site
• Fracture
• Prolonged bleeding requiring transfusion
• Infection near the biopsy site or in the bone

There may be other risks depending upon the site of the lesion or specific medical condition. Be sure to discuss any concerns with your ordering physician prior to the procedure.

• Bleeding disorders (Coagulation disorders)
• Inaccessible sites
• A patient who is unable to cooperate with positioning and instructions

• Do not drink or eat 6 hours before the procedure. If the procedure is scheduled in the morning, don’t drink or eat after midnight.
• Notify your ordering physician if you are sensitive to or are allergic to any medications, latex, tape, and anesthetic agents (local and general).
• Notify your ordering physician of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.
• Notify your ordering physician if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.
• If you are pregnant or suspect that you are pregnant, you should notify your ordering physician.
• You may receive a sedative prior to and during the procedure. Because the sedative may make you drowsy, you will need to arrange for someone to drive you home.

• The physician (usually musculoskeletal radiologist) will explain the procedure.
• You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
• You may undergo blood tests or other diagnostic tests.
• You may receive a sedative prior to the procedure to help you relax.

• Based upon your medical condition, the physician may request other specific preparation.

• Procedures are performed under a CT-guidance on an outpatient basis or as part of your stay in a hospital.
• Procedures may vary depending on your condition and your physician’s practices.
• Procedures are done under local anesthesia with intravenous conscious sedation and usually takes 1-2 hours. Intravenous sedation is given to help pain and anxiety.

• Your recovery process will vary depending upon the type of procedure that was performed.
• You will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged to your home.
• Once you are home, it is important to keep the biopsy area clean and dry. In general, you can take a shower next day. The biopsy site may be tender or sore for several days after the biopsy.
• Take a pain reliever for soreness as recommended. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.
• You may resume your usual diet and activities unless your physician advises you differently. Your physician may ask you to avoid strenuous physical activity for a few days.

Notify your ordering physician to report any of the following:

• fever
• redness, swelling, bleeding, or other drainage from the biopsy site