Abstract
Percutaneous, image-guided musculoskeletal biopsy, due to its minimal invasive nature,
when compared with open surgical biopsy, is a safe and effective technique which is
widely used in many institutions as the primary method to acquire tissue and bone
samples. Indications include histopathologic and molecular assessment of a musculoskeletal
lesion, exclusion of malignancy in a bone/vertebral fracture, examination of bone
marrow, and infection investigation. Preprocedural workup should include both imaging
(for lesion assessment and staging) and laboratory (including coagulation tests and
platelet count) studies. In selected cases, antibiotic prophylaxis should be administered
before the biopsy. Core needle biopsy of musculoskeletal lesions has a diagnostic
accuracy that ranges from 66 to 98% with higher diagnostic yield for lytic, large-size,
malignant lesions and when multiple and long specimens are obtained. Reported complication
rates range between 0 and 10% and usually do not exceed 5%, with a suggested threshold
of 2%. The purpose of this review article is to illustrate the technical aspects,
the indications, and the methodology of percutaneous image-guided bone biopsy that
will assist the interventional radiologist to perform these minimal invasive techniques.
Keywords
musculoskeletal lesion - percutaneous biopsy - Imaging guidance - interventional radiology
