Percutaneous aspiration bone biopsy by fluoroscopic guidance

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The advantages of percutaneous needle aspiration of skeletal lesions were described in 1931 by Coley et al.1 The availability of image intensification, biplane fluoroscopy, and improved bone scanning techniques makes this procedure more feasible.2 The procedure is done under local anesthetic with sterile preparation of the skin.

The reasons for percutaneous biopsy range from the patient who is a poor surgical risk to the patient with metastatic disease who does not need surgical intervention.2 In addition some biopsies are done for suspected infection. Percutaneous biopsy has few risks and complications have been minimal. The advantage of fluoroscopic guidance is the accurate localization of the biopsy needle in the suspected area. Coley et al1 have aptly stated that even though roentgenography can establish correct or nearly correct diagnosis in the majority of cases, histologic diagnosis is essential to avoid error. Aspiration is adaptable to all types of bone tumors, except those in which the tumor is deeply situated and surrounded by a zone of normal bone through which the needle cannot penetrate easily.1 Aspiration biopsy of bone is indicated in cases of infection or for metastatic neoplasms which require radiation or chemotherapy. However, the procedure is not limited to these two entities and has proved successful in the diagnosis of multiple myeloma1, 3, 4 and Paget’s disease of bone.4, 5 In addition, metabolic deficiency states such as osteoporosis and osteomalacia have been diagnosed with similar techniques.6 Open biopsy is of no advantage in these cases. Shortened hospital stay, or eliminated hospital . . .



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