A bone biopsy is a procedure in which a small sample of bone is taken from the body and looked

at under a microscope for cancer, infection, or other bone disorders. The sample of bone can be
removed by:

Inserting a needle through the skin and directly into the bone (closed or needle biopsy ).
A numbing medicine (local anesthetic) is used to prevent pain during this
procedure. Intravenous (IV) pain medicine and a sedative medicine also may be given.

Making a cut (incision) through the skin to expose an area of the bone (open
biopsy ). General anesthesia or medicine to block feeling in the area where the cut is
made (spinal anesthesia or a nerve block) is given for this procedure.

A bone biopsy can be taken from any bone in the body. It is easiest to get the biopsy samples
from bones that are close to the skin surface and away from any internal organs or
large blood vessels.
A bone biopsy is often done on bone areas that show problems on an X-ray. Computed
tomography (CT scan) or a bone scan may be used to guide the biopsy needle.

Why It Is Done
A bone biopsy is done to:

Confirm the diagnosis of a bone disorder (such as Paget's disease, a disease that may look
like bone cancer, or bone cancer) that was found by another test, such as an X-ray, CT
scan, bone scan, or a magnetic resonance imaging (MRI) scan.

Tell the difference between a noncancerous (benign) bone mass, such as a bone cyst, and
bone cancer, such as multiple myeloma.

See what is causing a bone infection (osteomyelitis) or if an infection is present.

Find the cause of ongoing bone pain.

Check bone problems seen on an X-ray.

An open bone biopsy allows your doctor to do surgical treatment at the same time, if needed.

How To Prepare
Before having a bone biopsy, tell your doctor if you:

Are taking any medicines. If you take medicines every day, ask your doctor whether you
should stop taking these medicines before the test.

Are allergic to any medicines, such as those used to numb the skin (anesthetics).

Have had bleeding problems or take blood thinners, such as aspirin, clopidogrel (Plavix),
or warfarin (Coumadin).

Are or might be pregnant.

 Take any herbal remedies. Some of these remedies may thin the blood

http://www.webmd.com/cancer/bone-biopsy#2

What is a bone biopsy?

A biopsy is a procedure done to remove tissue or cells from the body to be looked at under a
microscope. A bone biopsy is a procedure in which bone samples are removed (with a special biopsy
needle or during surgery) to find out 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.

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There are 2 types of biopsy:

Needle biopsy. After a local anesthetic is given, your healthcare provider makes a small cut
(incision) in your skin. He or she inserts the special biopsy needle into your bone to get a sample.
Open biopsy. After a general anesthetic is given, your healthcare provider makes a larger
incision in your skin and surgically removes a piece of bone. Depending on the lab findings, you
may need more surgery.
Other related procedures that may be used to help diagnose bone problems include CT scan, X-ray,
MRI of the bones, and bone scan.

Why might I need a bone biopsy?

Bone biopsies may be done to:

Evaluate bone pain or tenderness

Investigate an abnormality seen on X-ray
Find out if a bone tumor is cancer (malignant) or not cancer (benign)
Find the cause of an unexplained infection or inflammation
Your healthcare provider may have other reasons to recommend a bone biopsy.

What are the risks of a bone biopsy?

As with any surgical procedure, complications can happen. Some possible complications may include:
 Bruising and discomfort at the biopsy site
Bone fracture
Prolonged bleeding from the biopsy site
Infection near the biopsy site or in the bone
Other risks may exist, depending on your specific health condition. Be sure to discuss any concerns
with your healthcare provider before the procedure.

How do I get ready for a bone biopsy?

Your healthcare provider will explain the procedure to you. This is the time 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 health history, your healthcare provider may do a complete physical
exam. This is to make sure you are in good health before undergoing the procedure. You may have
blood tests or other diagnostic tests.
Tell your healthcare provider if you are allergic to any medicines, latex, tape, or anesthesia
(local and general).
Tell your healthcare provider about all medicines you take. This includes prescribed and over-
the-counter medicines, and herbal supplements.
Tell your healthcare provider if you have a history of bleeding disorders, or if you take any
blood-thinner (anticoagulant) medicines, aspirin, or other medicines that affect blood clotting. You
may need to stop taking these medicines before the procedure.
If you are pregnant or suspect that you are pregnant, tell your healthcare provider.
You may be asked to fast for 8 hours before the procedure, generally beginning at midnight of
the previous day. This is most likely if you are to have general anesthesia for the procedure.
You may get a sedative before 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 health condition, your healthcare provider may have other instructions for how
to prepare.

What happens during a bone biopsy?

A bone biopsy may be done on an outpatient basis, or as part of your stay in a hospital. Procedures
may vary, depending on your condition and your healthcare providers practices.

In addition, some biopsies may be done using local anesthesia to numb the area. Others may be done
under general or spinal anesthesia. If spinal anesthesia is used, you will have no feeling from your
waist down. Your healthcare provider will discuss this with you in advance.

Generally, a bone biopsy follows this process:

You will be asked to remove clothing and will be given a gown to wear.
An intravenous (IV) line may be started in your arm or hand.
You will be positioned so that your healthcare provider can easily reach the bone that is to be
sampled. A belt or strap may be used to hold you in the correct position.
The skin over the biopsy site will be cleansed with an antiseptic solution.
If a local anesthetic is used, you will feel a needle stick when the anesthetic is injected. This
may cause a brief stinging sensation. If general anesthesia is used, you will be put to sleep using
intravenous medicine.
If local anesthesia is used to numb the area, you will need to lie still during the procedure.
The provider will make a small cut (incision) over the biopsy site. He or she will insert the
biopsy needle into your bone.
If you are awake, you may feel discomfort or pressure when your healthcare provider takes the
bone sample.
The biopsy needle will be withdrawn, and firm pressure will be applied to the biopsy site for a
few minutes, until the bleeding has stopped.
Your healthcare provider will close the opening in your skin with stitches or skin adhesive
strips, if needed.
A sterile bandage or dressing will be applied.
The bone sample will be sent to the lab for examination.

What happens after a bone biopsy?

Your recovery process will vary, depending on the type of anesthesia that is given. You will be taken to
the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you
are alert, you will be taken to your hospital room or discharged to your home.
Once you are home, it is important to keep the biopsy area clean and dry. Your healthcare provider will
give you specific bathing instructions. If stitches are used, they will be removed during a follow-up
office visit. If adhesive strips are used, they should be kept dry and generally will fall off within a few
days.

The biopsy site may be tender or sore for several days after the bone biopsy. Take a pain reliever for
soreness as your healthcare provider recommends. Aspirin or certain other pain medicines may
increase the chance of bleeding. Be sure to take only recommended medicines.

Tell your healthcare provider if you have:

Fever or chills
Redness, swelling, bleeding, or other drainage from the biopsy site
Increased pain around the biopsy site
You may go back to your usual diet and activities unless your healthcare provider advises you
otherwise. Your provider may ask you to avoid strenuous physical activity for a few days.

Your healthcare provider may give you additional or alternate instructions after the procedure,
depending on your particular case.

Next steps
Before you agree to the test or the procedure make sure you know:

The name of the test or procedure

The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that persons qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how will you get the results
Who to call after the test or procedure if you have questions or problems
How much will you have to pay for the test or procedure

http://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/bone_bio
psy_92,p07672/

What Is a Bone Lesion Biopsy?

A bone lesion biopsy is a surgical procedure in which a doctor removes a sample of
your bone tissue and sends it to a laboratory for testing. The test typically
distinguishes between cancerous and noncancerous bone tumors and diagnoses
other bone abnormalities.

The procedure involves making a small incision, drilling into the bone, and removing
a sample of tissue from the lesion inside the bone. A lesion is an abnormality in the
 structure of the bone, which may or may not impact bone growth. Not all lesions are
cancerous.

Why Do I Need a Bone Lesion Biopsy?

Your doctor may order a bone lesion biopsy if there are signs of abnormalities in
your bones. These may show up on imaging scans, such as X-rays or CT scans. A
biopsy helps doctors determine if your bone lesions are the result of cancer,
infection, or another condition.

Conditions associated with bone tumors or lesions include:

coccidiomycosis (fungal infection)

Ewings sarcoma (cancerous bone tumor that affects children)
fibroma (benign tumor)
histoplasmosis (fungal infection)
multiple myeloma (cancer of the bone marrow involving plasma cells)
mycobacteria infection (tuberculosis)
osteoblastoma (benign bone tumor)
osteoid osteoma (benign bone tumor)
osteomalacia (softening of the bones due to a lack of vitamin D)
osteomyelitis (bone infection)
osteosarcoma (cancerous bone tumor that usually appears during
adolescence)
osteitis fibrosa (softening of the bones due to hyperparathyroidism)
rickets (weakening of the bones due to lack of calcium, vitamin D, or
phosphate)
Bone lesion biopsies can also provide surgeons with an inside view of your bones.
This is helpful when inspecting the status of infections or diseases that could be
candidates for amputation, such as osteomyelitis. In some cases, the biopsy can
help prevent the need for an amputation.

How Do I Prepare for a Bone Lesion Biopsy?

Prior to your surgery, youll have imaging tests to determine the location of your
bone lesions. Using these images, your surgeon will select the area from which they
will take a tissue sample.
 Youll also undergo a physical examination. This is a good time to tell your doctor
about any medications youre taking, including over-the-counter medicines or
supplements, and any allergies you may have.

Youll most likely have to fast for eight hours before your biopsy. This is standard
procedure, especially if youre undergoing general anesthesia.

What Happens During a Bone Lesion Biopsy?

The location and type of biopsy will determine the type of anesthesia you need. You
may have local, site-specific anesthesia, or you may need general anesthesia.
Under general anesthesia, youll be in a painless sleep during the entire biopsy.

During the procedure, your surgeon will make a small incision in your skin above the
bone where the sample will come from. What happens next depends on the type of
biopsy you are having.

In a needle biopsy, your surgeon will drill a small hole into the bone. Your surgeon
will extract a tissue sample using an instrument similar to a needle.

In an incisional biopsy, the surgeon will cut directly into the tumor to remove a
sample. This type of biopsy can retrieve a larger tissue sample.

After removing the sample, your doctor will stitch the incision wound closed and
bandage it. Theyll then send the tissue sample to a laboratory for testing.

What Are the Complications Associated with a

Bone Lesion Biopsy?
All surgical procedures carry risks of infection and bleeding, which are greater for
people with bleeding disorders or a compromised immune system. Tell your doctor if
you have either of these risk factors.

Other possible complications specific to bone lesion biopsies include:

damage to surrounding tissue

excessive bleeding
 bone fractures
infection of the bone or near the biopsy area
The risks of this test are significantly lower than the risk of not testing your bone
lesions. Testing can help detect cancers or other serious health problems so that
treatment can begin as quickly as possible.

What Happens After a Bone Lesion Biopsy?

After the biopsy, youll rest in a hospital bed until your doctor says you can go
home. You will be in charge of taking care of your incision wound, which includes
keeping the area clean and changing your bandages. Your doctor will remove your
stitches at a follow-up appointment. The site of the biopsy may be sore for a few
days after the procedure.

Your doctor will go over the results of your biopsy at a follow-up appointment.
Theyll tell you the results of the bone biopsy and outline a treatment program.

What Is Traction?
In the medical field, traction refers to the practice of slowly
and gently pulling on a fractured or dislocated body part. Its
often done using ropes, pulleys, and weights. These tools
help apply force to the tissues surrounding the damaged
area.

The purpose of traction is to guide the body part back into

place and hold it steady. Traction may be used to:

stabilize and realign bone fractures, such as a broken

arm or leg
help reduce the pain of a fracture before surgery
treat bone deformities caused by certain conditions,
such as scoliosis
correct stiff and constricted muscles, joints, tendons, or
skin
 stretch the neck and prevent painful muscle spasms

What Are the Different

Types of Traction?
The two main types of traction are skeletal traction and skin
traction. The type of traction used will depend on the location
and the nature of the problem.

Skeletal Traction
Skeletal traction involves placing a pin, wire, or screw in the
fractured bone. After one of these devices has been inserted,
weights are attached to it so the bone can be pulled into the
correct position. This type of surgery may be done using a
general, spinal, or local anesthetic to keep you from feeling
pain during the procedure.

The amount of time needed to perform skeletal traction will

depend on whether its a preparation for a more definitive
procedure or the only surgery thatll be done to allow the
bone to heal.

Skeletal traction is most commonly used to treat fractures of

the femur, or thighbone. Its also the preferred method when
greater force needs to be applied to the affected area. The
force is directly applied to the bone, which means more
weight can be added with less risk of damaging the
surrounding soft tissues.

Skin Traction
Skin traction is far less invasive than skeletal traction. It
involves applying splints, bandages, or adhesive tapes to the
skin directly below the fracture. Once the material has been
applied, weights are fastened to it. The affected body part is
then pulled into the right position using a pulley system
attached to the hospital bed.

Skin traction is used when the soft tissues, such as the

muscles and tendons, need to be repaired. Less force is
applied during skin traction to avoid irritating or damaging
the skin and other soft tissues. Skin traction is rarely the only
treatment needed. Instead, its usually used as a temporary
way to stabilize a broken bone until the definitive surgery is
performed.

Cervical Traction
During cervical traction, a metal brace is placed around your
neck. The brace is then attached to a body harness or
weights, which are used to help correct the affected area.
Cervical traction is performed using a general anesthetic, so
youll be asleep throughout the entire procedure.

Cervical traction might be used in two different situations.

First, it may be done to gently stretch the neck muscles so
muscle spasms can be relieved or prevented. It may also be
performed to immobilize the spine after a neck injury.

What Happens After

Traction?
If youre treated with traction, youll probably need to
participate in an inpatient or an outpatient treatment
program. These programs often consist of physical and
occupational therapy to help you regain your strength and
relearn skills that may have been affected by your injury. A
therapist can also teach you new skills to compensate for any
pain, weakness, or paralysis you may have experienced as a
result of being injured.
 The first few days after traction is performed can be difficult.
The muscles are often weak since you must spend a lot of
time in bed after traction is performed. Moving around and
walking may be challenging and can make you tired.
However, its important to stick with any rehabilitation
program so that you can improve your chances of making a
complete recovery.

What Are the Risks of

Traction?
There are risks involved in all surgical procedures. These risks
include:

an adverse reaction to the anesthesia

excessive bleeding
an infection of the pin site
damage to the surrounding tissue
nerve injury or vascular injury from too much weight
being applied
Its important to contact your doctor if:

the prescribed medications arent relieving your pain

the skin around the pin site becomes red, hot, or swollen
theres drainage

Is Traction an Effective
Treatment?
Traction used to be considered a state-of-the-art treatment. In
recent years, however, other surgical techniques have
become more advanced and more effective in correcting
fractures, damaged muscles, and spinal conditions. Traction
also doesnt allow for much movement after surgery, so the
recovery time is often much longer. Today, its used primarily
as a temporary measure until the definitive procedure is
done. Traction saved many lives during World War II by
allowing soldiers to be transported safely without injury to
their surrounding tissues.

However, traction can be beneficial in treating certain

conditions. Its very effective in providing temporary pain
relief in the early stages of treatment after trauma.

You and your doctor can discuss whether traction is the best
option for your particular condition.
http://www.healthline.com/health/traction#Effectiveness5