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Bone lesion biopsy

Definition

A bone lesion biopsy is the removal of a piece of bone or bone marrow for examination.

Alternative Names

Bone biopsy; Biopsy - bone

How the test is performed

The health care provider applies a numbing medicine (local anesthetic) to the area, and makes a small cut in the skin. A special drill needle is usually used. The biopsy needle is pushed and twisted into the bone.

Once the sample is obtained, the needle is twisted out and the sample is sent for examination. Pressure is applied to the site. Once bleeding stops, stitches are applied, and covered with a bandage.

Bone biopsy may also be done under general anesthesia to remove a larger sample. This may allow for immediate surgery to remove the bone if the exam shows that there is an abnormal growth or cancer.

How to prepare for the test

You may be told not to drink or eat anything for several hours before the biopsy.

How the test will feel

With a needle biopsy, you may feel moderate discomfort and pressure, even though a local anesthetic is used. You must remain still during the procedure.

After the biopsy, the area may be sore or tender for several days.

Why the test is performed

The most common reasons for bone lesion biopsy are to tell the difference between cancerous and noncancerous bone tumors and to identify other bone problem. It may be performed on people with bone pain and tenderness, particularly if x-ray, CT scan, or other testing reveals a problem.

Normal Values

Normal bone appears as two types: compact and cancellous.

  • Compact bone is dense and contains layers of mineral deposits called lamellae.
  • Cancellous bone looks porous, with widely spaced mineral deposits, and red and yellow marrow in the center of the bone.

What abnormal results mean

Benign bone tumors include:

Cancerous tumors include:

Abnormal results may also be due to:

What the risks are

  • Bone fracture
  • Bone infection (osteomyelitis)
  • Damage to surrounding tissue
  • Discomfort
  • Excessive bleeding
  • Infection near the biopsy area

Note: Some people with bone disorders also have blood clotting disorders, which can increase the risk for bleeding.

Special considerations

Signs of bone infection (one of the most serious risks) include fever, headache, pain with movement, redness and swelling of the tissues around the biopsy site, and drainage of pus from the biopsy site. If these occur, seek immediate medical attention.

References

Zink BJ, Raukar NP. Bone and joint infections. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 134.

Schwartz HS, Holt GE. Bone tumors. In:Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 34.


Review Date: 8/11/2012
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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