Bone Biopsy

None.

• To diagnose bone diseases such as osteoporosis, osteomalacia, and osteopenia when less invasive tests fail to provide definitive results.
• To distinguish between benign bone tumors and bone cancer.
• To determine which organism may be causing osteomyelitis.

A sample of the bone is removed and sent to a laboratory for analysis.

• For diagnosing suspected cases of osteoporosis, osteomalacia, and osteopenia, you will be given oral tetracycline (an antibiotic) three weeks prior to the procedure. You will be given another dose just before the biopsy.
• You may not eat or drink on the morning of the procedure.
• You remove all clothing and don a hospital gown.

• Local anesthesia is administered at the biopsy site. (Occasionally general anesthesia may be used.) The anesthetic is injected into the skin and sometimes into the portion of the bone itself where the nerve fibers run.
• A sedative is given intravenously.
• A hollow needle is introduced into your body and guided to the area of suspected bone abnormality with the help of a fluoroscope or CT scanner.
• In cases of systemic (affecting the entire body) bone disease, such as osteoporosis, the pelvic bone is usually used because it is close to the surface of the skin. The site is determined by measuring a specific distance from the hip bone, making a scanner unnecessary.
• A tiny core of bone (a bit more than ¹/₆ of an inch in diameter) is removed with the help of a ratchetlike device on the needle. A sample of the synovium, the lining covering bone cartilage, may also be removed.
• Bone tissue obtained during the biopsy is sent to a laboratory for analysis.

• A pressure bandage is applied to the biopsy site, and you may be asked to lie on the site to apply additional pressure.
• If the biopsy was performed on the spine, you may have to spend 24 hours in the hospital. Otherwise you may leave in about an hour, assuming there is no bleeding (a rare complication) and that your pulse, blood pressure, breathing, and temperature are found to be normal.
• You should have someone drive you home, as you may experience some discomfort at the biopsy site.
• You must keep the biopsy site covered and dry (showers are okay, baths are not) for 48 hours.
• If you experience pain or discomfort, take acetaminophen (Tylenol, etc) or acetaminophen with codeine.
• Let your doctor know immediately if you experience bleeding through the bandage or signs of infection such as fever, pain on movement, or redness near the biopsy site.

The site at which the biopsy is performed: If the site is not carefully chosen, cancer cells or other cells affected by disease may be missed; if bone density is measured, the density may vary depending on the part of the bone examined.

The shape and appearance of bone cells are analyzed under a microscope in order to distinguish benign tumors from cancer. The presence of cells that play a role in inflammation may signal an inflammatory disorder, such as osteomyelitis. The sample may be stained with special dyes to detect other abnormalities, and certain chemicals in the tissue may be labeled so that they can be detected and measured. For example, low levels of certain minerals may lead to a diagnosis of osteomalacia, a disorder characterized by bone softening in adults.

It may establish definitive diagnosis without surgery.

It's invasive.

A positive test indicates that treatment may begin.