(Biopsy-Bone, Bone Lesion Biopsy)

Procedure overview

What is a bone biopsy?

A biopsy is a procedure performed to remove tissue or cells from the body for examination under a microscope. A bone biopsy is a procedure in which bone samples are removed (with a special biopsy needle or during surgery) to determine if cancer or other abnormal cells are present. A bone biopsy involves the outer layers of bone, unlike a bone marrow biopsy, which involves the innermost part of the bone.

There are two types of biopsy:

  • Needle biopsy. After a local anesthetic is given, the doctor makes a small incision in the skin and inserts the special biopsy needle into the bone to obtain a sample.

  • Open biopsy. After a general anesthetic is given, the doctor makes a larger incision in the skin and surgically removes a piece of bone. Depending upon the lab findings, further surgery may be performed.

Other related procedures that may be used to help diagnose bone problems include computed tomography (CT scan), X-ray, magnetic resonance imaging (MRI) of the bones, and bone scan. Please see these procedures for additional information.

What is bone?

Bone is living tissue that makes up the body's skeleton. There are three types of bone tissue:

  • Compact tissue. The harder, outer tissue of bones.

  • Cancellous tissue. The sponge-like tissue inside bones.

  • Subchondral tissue. The smooth tissue at the ends of bones, which is covered with another type of tissue called cartilage. Cartilage is the specialized, gristly connective tissue that is present in adults, and is the tissue from which most bones develop in children.

Bone provides shape and support for the body, as well as protection for some organs. Bone also serves as a storage site for minerals and supplies the marrow from which blood cells are developed and then stored.

Reasons for the procedure

Bone biopsies may be performed to:

  • Evaluate bone pain or tenderness

  • Investigate an abnormality seen on X-ray

  • Determine if a bone tumor is malignant (cancerous) or benign

  • Determine the cause of an unexplained infection or inflammation

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

Risks of the procedure

As with any surgical procedure, complications can occur. Some possible complications may include, but are not limited to, the following:

  • Bruising and discomfort at the biopsy site

  • Bone fracture

  • Prolonged bleeding from the biopsy site

  • Infection near the biopsy site or in the bone

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

Before the procedure

  • Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about 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.

  • In addition to a complete medical history, your doctor may perform a complete physical examination to ensure you are in good health before undergoing the procedure. You may undergo blood tests or other diagnostic tests.

  • Notify your doctor if you are sensitive to or are allergic to any medications, latex, tape, and anesthetic agents (local and general).

  • Notify your doctor of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.

  • Notify your doctor 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 doctor.

  • You may be asked to fast for eight hours before the procedure, generally after midnight. This is most likely if you are to have general anesthesia for the procedure.

  • You may receive a sedative prior to the procedure to help you relax. Because the sedative may make you drowsy, you will need to arrange for someone to drive you home.

  • Based on your medical condition, your doctor may request other specific preparation.

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