What is a Bone Biopsy?

A procedure done to remove tissue or cells that will be used for further examination is called a Biopsy. A bone biopsy is a medical procedure in which bone tissue is removed and analysed for accurate diagnosis of various bone-related conditions. It is commonly used to determine the severity of bone diseases for early detection and intervention. Such a procedure can be done to identify and target serious bone conditions and improve the overall health of patients.

 

Purpose Bone Biopsies

Diagnosing Bone Diseases

The main reason people undergo a bone biopsy is to diagnose a bone disease and determine how severe it is. It is primarily used to diagnose conditions like osteosarcoma, Ewing’s sarcoma, and non-cancerous conditions like osteoporosis or other bone infections.

 

Evaluation of Bone Infections

Biopsies can help to identify the type of bacteria or organism causing an infection.

 

Monitoring of Treatments

For some patients, a biopsy is done as a follow-up to assess the effectiveness of an ongoing treatment for a bone condition.

Types of Bone Biopsies

When considering a bone biopsy, there are two primary types that exist. A Needle Biopsy and an Open biopsy are both procedures that can be used to diagnose bone-related disease or dysfunction. These two approaches differ with respect to their invasiveness.

Let us explore the details of these two procedures:

 

Needle Biopsy (Percutaneous Bone Biopsy)

Procedure: The patient is put under local anaesthesia. Usually, the biopsy site is numbed while the patient remains awake. A long and hollow needle is then inserted and used to extract a small sample of bone tissue. The procedure is made easy with the use of imaging techniques like X-rays, Computerised Tomography (CT) scans or a Magnetic Resonance Image (MRI) to ensure the needle is inserted appropriately.

Use: This procedure is ideal when the area of concern is easy to access and only a small tissue sample is needed for diagnosis.

Advantages: Due to it being a less invasive method, it has a quicker recovery time and fewer complications. There is also a reduced hospital time and scarring is minimal.

Limitations: Since the sample taken is usually small, in some instances it may not be sufficient for a definitive diagnosis. In certain cases, it can miss the area of concern resulting in a repeat biopsy procedure.

 

Open Biopsy (Surgical Bone Biopsy)

Procedure: The patient is put under general anaesthesia and is not conscious during the procedure.  This invasive procedure begins with an incision in the skin to fully remove a piece of bone tissue.

Use: This procedure is typically needed when a larger bone sample is required for diagnosis. It is often done when the affected area is not easily accessible or when previous needle biopsies have not provided a clear diagnosis.

Advantages: Although invasive, the larger sample size can provide a more comprehensive analysis. This increases the chances of a more successful outcome for the patient and a more accurate diagnosis for certain complex disease cases.

Limitations: With any surgical orthopaedic procedure, there is a risk of complications including infection, blood loss, long recovery period or hospital stay and it may result in more permanent scarring. 

Core Needle Scarring

A third alternative to the primary mechanisms of bone biopsy is a core needle biopsy. This procedure is an intermediary between the needle and open biopsies and involves a slightly larger needle. This needle is able to obtain a bigger tissue sample than a standard needle biopsy but is less invasive than an open biopsy. Following all procedures, the extracted bone tissue undergoes a detailed analysis at a pathology laboratory. 

Deciding which type of bone biopsy to undergo is dependent on several factors. The location of the affected area and its size will determine which is the best approach. Understanding the suspected bone disease/condition as well as an examination of the patient’s overall health and previous medical records also helps in choosing a suitable procedure with the best possible outcome.

When Should You Consider a Bone Biopsy?

Bone health is an aspect of overall well-being that is often overlooked. Bone biopsies serve as critical diagnostic tools in the management of bone health. You should consider a bone biopsy when monitoring any bone conditions or when diagnosing an area of concern. 

They are often considered for the following reasons:

• Suspected Bone Cancer
• Chronic and Complex Bone infections
• Unexplained bone pain following blood/imaging tests
• Monitoring and evaluation of treatments

A bone biopsy will be avoided when the procedure might pose serious risks for the patient or when alternative methods offer a definitive diagnosis. It is only considered after a comprehensive assessment of the patient’s symptoms, medical records, physical health, imaging and lab tests.

 

How Biopsy Results Influence Treatment Plans

In a histological examination, the bone tissue is analysed under a microscope to identify cell types, structures or any abnormalities. Other specialised testing like may be performed on the sample to give a more targeted analysis. 

Following the evaluation of the sample, various bone conditions can either be confirmed or ruled out. The physician or orthopaedic specialist will discuss the results of the biopsy and its complications with the patient.

A treatment plan will then be created guided by the outcome of the biopsy and the patient’s medical evaluation prior to the procedure. If cancer is diagnosed, surgery may be suggested as well as chemotherapy, radiation therapy or a combination of all three.

Regular follow-ups are crucial, particularly in cases where Cancer is diagnosed. This will require further imaging and blood tests as well as a physical examination. Follow-ups are also crucial for recovery and appropriate post-procedure care.

 

Bone Biopsies are Crucial for Managing Bone Health.

A bone biopsy can provide an accurate diagnosis of an unexplained bone condition. Successful diagnosis can allow for early intervention of serious diseases like cancer providing effective treatment. It is also beneficial in guiding effective treatments for complex bone conditions where previous testing has provided inconclusive results.

 

Find out about other Orthopaedic procedures and managing your bone health at GlobMed.