Biopsy for joints and bones

Bone biopsy uses a needle and image guidance to remove a small sample of bone for examination under a microscope. Bone biopsies may be used to confirm the diagnosis of a bone disorder, investigate an abnormality, determine the cause of pain or infection, or distinguish a bone tumor from other conditions. Needle biopsy is less invasive than surgical biopsy and may not require general anesthesia.

In the case of a closed bone biopsy, a special drill needle is used. The needle is usually several centimeters long and has a hollow center to capture the bone sample.

The CT or x-ray scanner is a large, box-like machine with a hole, or short tunnel, in the center. You lie on a narrow examination table that slides in and out of this tunnel. The x-ray tube and electronic x-ray detectors are placed opposite each other on a ring, called a gantry, that rotates around you. The computer workstation that processes image information is located in a separate control room, where the technologist operates the scanning device and monitors your examination in direct eye contact, and usually with the ability to listen and talk to you through the use of a speaker and microphone.

Other equipment that may be used during the procedure includes an intravenous line, an ultrasound machine, and devices that monitor your heartbeat and blood pressure.

The doctor inserts a needle through the skin and pushes it into the bone. A second needle is then inserted through the first needle, and a sample of bone is removed. The needles are then removed. The procedure is usually image-guided.

You will feel a small prick from the needle when you receive the local anesthetic to numb your skin. You may also feel a little pressure when the biopsy needle is inserted, and a little pain or pressure when the bone sample is removed.

After the procedure, the biopsy site may remain sore for up to a week. You should consult your physician about pain medications.

You should call your doctor if the biopsy site bleeds excessively, or if you notice any signs of infection such as: increased pain, swelling, redness or temperature of the site, pus draining from the site, swollen lymph nodes in the neck, armpits or groin, chills, or fever.

The sample obtained by the radiologist will be analyzed by pathologists and microbiologists, and may take up to five or seven days to obtain the final result. The doctor in charge will communicate the results to you.