Semin Musculoskelet Radiol 2011; 15(5): 561-568
DOI: 10.1055/s-0031-1293501
© Thieme Medical Publishers

Imaging-Guided Biopsy in Musculoskeletal Infections

Sivasubramanian Srinivasan1 , Wilfred C.G. Peh1
  • 1Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Alexandra Health, Singapore, Republic of Singapore
Further Information

Publication History

Publication Date:
11 November 2011 (online)

ABSTRACT

Biopsies may be required in patients suspected to have musculoskeletal infections to confirm the diagnosis and also to identify the causative organism. Imaging-guided biopsies have gained increased acceptance to obtain various types of tissues for diagnosis. Under image guidance, biopsies are done percutaneously, usually under local anesthesia. They are relatively safe, and complications are significantly less compared with open biopsies. In this article, we review the planning, indications, technique, and complications of imaging-guided percutaneous biopsy performed for musculoskeletal infections.

REFERENCES

  • 1 Rankine J J, Barron D A, Robinson P, Millner P A, Dickson R A. Therapeutic impact of percutaneous spinal biopsy in spinal infection.  Postgrad Med J. 2004;  80 (948) 607-609
  • 2 Michel S C, Pfirrmann C W, Boos N, Hodler J. CT-guided core biopsy of subchondral bone and intervertebral space in suspected spondylodiskitis.  AJR Am J Roentgenol. 2006;  186 (4) 977-980
  • 3 Gupta S, Wallace M J, Cardella J F, Kundu S, Miller D L, Rose S C. Society of Interventional Radiology Standards of Practice Committee . Quality improvement guidelines for percutaneous needle biopsy.  J Vasc Interv Radiol. 2010;  21 (7) 969-975
  • 4 Gogna A, Peh W CG, Munk P L. Image-guided musculoskeletal biopsy.  Radiol Clin North Am. 2008;  46 (3) 455-473 v
  • 5 Wu J S, Gorbachova T, Morrison W B, Haims A H. Imaging-guided bone biopsy for osteomyelitis: are there factors associated with positive or negative cultures?.  AJR Am J Roentgenol. 2007;  188 (6) 1529-1534
  • 6 deSantos L A, Lukeman J M, Wallace S, Murray J A, Ayala A G. Percutaneous needle biopsy of bone in the cancer patient.  AJR Am J Roentgenol. 1978;  130 (4) 641-649
  • 7 Schweitzer M E, Deely D M, Beavis K, Gannon F. Does the use of lidocaine affect the culture of percutaneous bone biopsy specimens obtained to diagnose osteomyelitis? An in vitro and in vivo study.  AJR Am J Roentgenol. 1995;  164 (5) 1201-1203
  • 8 Peh W CG. CT-guided percutaneous biopsy of spinal lesions.  Biomed Imaging Interv J. 2006;  2 (3) e25
  • 9 Chew F S, Kline M J. Diagnostic yield of CT-guided percutaneous aspiration procedures in suspected spontaneous infectious diskitis.  Radiology. 2001;  218 (1) 211-214
  • 10 Kattapuram S V, Rosenthal D I. Percutaneous biopsy of skeletal lesions.  AJR Am J Roentgenol. 1991;  157 (5) 935-942
  • 11 Haaga J R, LiPuma J P, Bryan P J, Balsara V J, Cohen A M. Clinical comparison of small- and large-caliber cutting needles for biopsy.  Radiology. 1983;  146 (3) 665-667
  • 12 Coucher J R, Dimmick S J. Coaxial cutting needle biopsies: how important is it to rotate the cutting needle between passes?.  Clin Radiol. 2007;  62 (8) 808-811
  • 13 Roberts C C, Morrison W B, Leslie K O, Carrino J A, Lozevski J L, Liu P T. Assessment of bone biopsy needles for sample size, specimen quality and ease of use.  Skeletal Radiol. 2005;  34 (6) 329-335
  • 14 Logan P M, Connell D G, O'Connell J X, Munk P L, Janzen D L. Image-guided percutaneous biopsy of musculoskeletal tumors: an algorithm for selection of specific biopsy techniques.  AJR Am J Roentgenol. 1996;  166 (1) 137-141
  • 15 Pierot L, Boulin A. Percutaneous biopsy of the thoracic and lumbar spine: transpedicular approach under fluoroscopic guidance.  AJNR Am J Neuroradiol. 1999;  20 (1) 23-25
  • 16 Gupta S, Takhtani D, Gulati M et al.. Sonographically guided fine-needle aspiration biopsy of lytic lesions of the spine: technique and indications.  J Clin Ultrasound. 1999;  27 (3) 123-129
  • 17 Civardi G, Livraghi T, Colombo P, Fornari F, Cavanna L, Buscarini L. Lytic bone lesions suspected for metastasis: ultrasonically guided fine-needle aspiration biopsy.  J Clin Ultrasound. 1994;  22 (5) 307-311
  • 18 Le H B, Lee S T, Munk P L. Image-guided musculoskeletal biopsies.  Semin Intervent Radiol. 2010;  27 (2) 191-198
  • 19 Rubens D J, Fultz P J, Gottlieb R H, Rubin S J. Effective ultrasonographically guided intervention for diagnosis of musculoskeletal lesions.  J Ultrasound Med. 1997;  16 (12) 831-842
  • 20 Carrino J A, Khurana B, Ready J E, Silverman S G, Winalski C S. Magnetic resonance imaging-guided percutaneous biopsy of musculoskeletal lesions.  J Bone Joint Surg Am. 2007;  89 (10) 2179-2187
  • 21 Blanco Sequeiros R, Carrino J A. Musculoskeletal interventional MR imaging.  Magn Reson Imaging Clin N Am. 2005;  13 (3) 519-532
  • 22 White L M, Schweitzer M E, Deely D M, Gannon F. Study of osteomyelitis: utility of combined histologic and microbiologic evaluation of percutaneous biopsy samples.  Radiology. 1995;  197 (3) 840-842
  • 23 Welker J A, Henshaw R M, Jelinek J, Shmookler B M, Malawer M M. The percutaneous needle biopsy is safe and recommended in the diagnosis of musculoskeletal masses.  Cancer. 2000;  89 (12) 2677-2686
  • 24 Mankin H J, Mankin C J, Simon M A. Members of the Musculoskeletal Tumor Society . The hazards of the biopsy, revisited.  J Bone Joint Surg Am. 1996;  78 (5) 656-663
  • 25 Sehn J K, Gilula L A. Percutaneous needle biopsy in diagnosis and identification of causative organisms in cases of suspected vertebral osteomyelitis.  Eur J Radiol. 2011;  March 31 (Epub ahead of print)
  • 26 Jaramillo-de la Torre J J, Bohinski R J, Kuntz IV C. Vertebral osteomyelitis.  Neurosurg Clin N Am. 2006;  17 (3) 339-351 vii
  • 27 Carragee E J. Pyogenic vertebral osteomyelitis.  J Bone Joint Surg Am. 1997;  79 (6) 874-880
  • 28 Hadjipavlou A G, Kontakis G M, Gaitanis J N, Katonis P G, Lander P, Crow W N. Effectiveness and pitfalls of percutaneous transpedicle biopsy of the spine.  Clin Orthop Relat Res. 2003;  411 (411) 54-60
  • 29 Colmenero J D, Jiménez-Mejías M E, Reguera J M et al.. Tuberculous vertebral osteomyelitis in the new millennium: still a diagnostic and therapeutic challenge.  Eur J Clin Microbiol Infect Dis. 2004;  23 (6) 477-483
  • 30 Chew F S, Kline M J. Diagnostic yield of CT-guided percutaneous aspiration procedures in suspected spontaneous infectious diskitis.  Radiology. 2001;  218 (1) 211-214
  • 31 Cottle L, Riordan T. Infectious spondylodiscitis.  J Infect. 2008;  56 (6) 401-412
  • 32 Michel S CA, Pfirrmann C WA, Boos N, Hodler J. CT-guided core biopsy of subchondral bone and intervertebral space in suspected spondylodiskitis.  AJR Am J Roentgenol. 2006;  186 (4) 977-980

Wilfred C.G. PehM.D. 

Department of Diagnostic Radiology, Khoo Teck Puat Hospital

Alexandra Health, 90 Yishun Central, Singapore 768828, Republic of Singapore

Email: wilfred.peh@gmail.com

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