A bone biopsy is a medical procedure used to collect a small sample of bone tissue for laboratory analysis. This tissue sample is examined under a microscope to help physicians diagnose various conditions affecting the skeletal system. Common reasons for a bone biopsy include investigating abnormalities seen on X-rays, determining if a bone tumor is benign or malignant, or finding the cause of a persistent bone infection or inflammation.
Preparing for the Procedure
Before the biopsy, the medical team provides specific instructions to minimize complications. A detailed review of the patient’s medical history is mandatory, focusing on allergies to medications, latex, or anesthesia. Patients must inform their healthcare provider about all current medications and supplements, especially blood thinners like aspirin or anticoagulants, which increase the risk of bleeding.
Patients are instructed to stop taking blood-thinning medications several days before the procedure. Blood tests are often performed beforehand to check clotting factors and ensure readiness. If the procedure requires general anesthesia or conscious sedation, fasting is required for about eight hours prior to the appointment. Finally, the patient must sign a consent form, confirming they understand the procedure and its potential risks.
The Step-by-Step Biopsy Process
Upon arrival, the patient changes into a gown, and an intravenous (IV) line may be started for administering necessary medications. The type of anesthesia used depends on the bone’s location and the chosen biopsy method. Options range from local anesthetic to conscious sedation or general anesthesia. If local anesthetic is used, the patient will feel a brief stinging sensation as the numbing agent is injected.
The patient is positioned to allow the physician easy access to the biopsy site, sometimes secured to prevent movement. The skin over the target area is cleaned with an antiseptic solution to reduce infection risk. Modern bone biopsy uses imaging guidance, such as computed tomography (CT) or fluoroscopy, which provides real-time visualization to precisely target the lesion.
The physician uses imaging guidance to determine the exact entry point and needle trajectory. A small incision is made to allow the specialized biopsy instrument to pass through. The biopsy needle, often a trocar system, is carefully advanced through the soft tissue and into the outer layer of the bone. As the needle enters the bone, the patient may feel pressure or discomfort, even with local anesthetic.
Once the needle reaches the target area, a smaller inner needle is advanced to cut and capture the core sample of bone tissue. This specialized needle extracts a solid piece of bone, which is then removed and preserved for laboratory analysis. After the sample is secured, the instruments are withdrawn. Firm pressure is immediately applied to the biopsy site for several minutes to stop any bleeding. The small opening is then closed with adhesive strips or stitches, and a sterile dressing is applied.
Recovery and Post-Procedure Care
After the procedure, the patient is moved to a recovery area where nurses monitor vital signs until the effects of sedation have worn off. Pain management begins immediately, and patients are advised to use over-the-counter pain relievers, such as acetaminophen, for soreness. Patients must avoid aspirin or other non-steroidal anti-inflammatory drugs unless authorized by the doctor, as these interfere with blood clotting.
Once discharged, a responsible adult must drive the patient home and stay with them for the first night. For the first 24 to 48 hours, patients must avoid strenuous activity, heavy lifting, or movements that strain the biopsy area. The dressing should be kept clean and dry. Instructions will specify when the dressing can be changed and when showering is permitted, usually 24 to 48 hours after the procedure.
The biopsy site may feel tender or sore for up to a week. Patients must monitor the site for any signs of complications requiring immediate medical attention. Warning signs include persistent fever or chills, worsening redness or swelling, excessive bleeding from the wound, or pain that significantly increases despite medication.