Percutaneous Musculoskeletal Biopsy

The procedure provides a rapid way to diagnose cancers and noncancer conditions.

Percutaneous needle technique musculoskeletal biopsy is a procedure to obtain a small piece of tissue (biopsy) from the muscles and/or the bones. It is performed by passing a special type of needle through the skin (percutaneously) under image guidance (e.g., computed tomography [CT] scan, magnetic resonance imaging [MRI]). The procedure provides an accurate, rapid, and cost-effective method for helping doctors diagnose cancers and noncancer conditions. 

Percutaneous needle technique biopsy can lead to a rapid and accurate diagnosis if a medical condition cannot be diagnosed accurately by physical examination, imaging studies, and laboratory values. Most percutaneous needle technique musculoskeletal biopsies can be performed using local anesthesia, with an addition of light sedation if needed. Various imaging techniques, such as CT, fluoroscopy, ultrasonography (USG), and MRI, can be used to target the lesion. The procedure is safe and major complications are rarely observed. 

Before the procedure, your doctor may:

• Order some blood tests and imaging studies (e.g., X-ray, ultrasonography, CT scan, and MRI).
• Ask you about any chronic health conditions you may have.
• Ask you about any medications you are on.
• Ask about any allergies you may have.
• Explain the biopsy procedure in detail, including possible complications, and address your doubts and concerns related to the procedure.
• Obtain your written consent.
• Ask you to not eat or drink anything for a few hours before the procedure.

During the procedure:

• You may be asked to wear a hospital gown.
• You will be comfortably positioned on the operating table/bed depending on the site of biopsy.
• The doctor administers local/regional anesthesia. General anesthesia may be required for procedures that are expected to be lengthy, complicated, or painful and if you are severely anxious or frightened.
• You may be given intravenous drugs to keep you sedated and comfortable during the procedure.
• The doctor will clean the area from where the biopsy is to be done.
• They will insert a specialized needle through the skin under image guidance (USG/CT/MRI/fluoroscopy).
• Once the needle reaches the desired site, a small piece of tissue (biopsy) is collected.
• The dressing is done.
• The biopsy sample is sent for examination by a pathologist and examined under a microscope.
• You may be asked to lie in a particular position for some time to avoid pressure at the biopsy site
• The doctor or nurse will regularly record your vitals and look for any complications.

The percutaneous needle technique musculoskeletal biopsy is a safe procedure with low chances of complications. The risk largely depends on the type of needle selected and the site of the biopsy. The reported incidence of complications is in the range of 0-10% with significant complications’ risk being less than 1%.

The complications may include:

• Bleeding
• Infections
• Nerve injury
• Pneumothorax (entrapment of air in the chest)
• Fracture
• Tumor seeding or spillage along the biopsy needle track