HISTORY:
CT DOSE:
SEDATION: Monitored by the IR registered nurse or surrogate, an independent trained observer providing Moderate Sedation with fentanyl.
CONSENT: Following discussion procedure its risks benefits (including bleeding and vessel damage) and alternatives, review of readily available relevant imaging prior to the procedure informed consent was obtained witnessed and documented upon the chart. Standard presurgical timeout confirming patient procedure and when relevant side and site was performed. Any discrepancies were resolved via consultation with appropriate readily available data sources. The patient was prepared and draped in standard sterile fashion.
PROCEDURE: Informed consent was obtained from the patient after explanation of the risks and benefits including risk of bleeding, nerve damage, infection, and iatrogenic fracture injuries of the bones. Patient had no further questions and agreed to the procedure.
Patient was placed prone on the CT interventional table and the [ ] back region was widely prepped and draped in the usual sterile fashion and local anesthesia was achieved using 1% lidocaine. Timeout procedure was performed.
Under sterile CT guidance, a 13-gauge bone marrow biopsy needle and stylette were carefully advanced into the ilium and into the body of the iliac bone. At this the outer needle was further advanced into the lesion and through the lesion without the stylet using a drill. This resulted in obtaining a large core biopsy of the trabecula and bone. This 2cm bone plug specimen was sent in a separate container. Patient suffered no immediate complications. No sedation or procedural complications occurred.
IMPRESSION:
Successful CT-guided core biopsy of the left iliac bone lesion.
Frequently Asked Questions
What is a CT-guided bone biopsy?
A CT-guided bone biopsy is a procedure that uses computed tomography (CT) imaging to help guide a needle to a specific area of bone to collect a tissue sample. This technique allows for precise targeting of lesions within the bone, aiding in the diagnosis of various conditions, such as infections, tumors, or other bone disorders.
During a CT-guided bone biopsy, the patient is placed on a CT table, and the area of interest is scanned to determine the exact location for the biopsy. After administering local anesthesia, a biopsy needle is inserted into the bone under CT guidance to obtain a tissue sample. The procedure is typically performed by an interventional radiologist and takes about 30 minutes to an hour.
What are the risks of a CT-guided bone biopsy?
Risks associated with a CT-guided bone biopsy include bleeding, infection, nerve damage, and fracture of the bone being sampled. However, these complications are rare, and the procedure is generally considered safe. Discussing potential risks and benefits with your healthcare provider is important before undergoing the procedure.
Is sedation required for a CT-guided bone biopsy?
Sedation is not always required for a CT-guided bone biopsy, but moderate sedation may be administered to help the patient remain comfortable. This involves the use of medications like fentanyl, monitored by a registered nurse or trained observer. Local anesthesia is usually sufficient to numb the biopsy site.
How should I prepare for a CT-guided bone biopsy?
Preparation for a CT-guided bone biopsy includes discussing the procedure with your doctor and signing an informed consent form. You may need to fast for a few hours beforehand, depending on the sedation plan. It's important to notify your doctor about any medications you are taking, especially blood thinners, as these may need to be adjusted.
What should I expect after a CT-guided bone biopsy?
After a CT-guided bone biopsy, you may experience some soreness or bruising at the biopsy site. Most patients can resume normal activities within a day. It's important to follow any specific post-procedure instructions provided by your healthcare team and watch for signs of infection or excessive bleeding, which should be reported immediately.
Why is a CT-guided bone biopsy necessary?
A CT-guided bone biopsy is necessary when imaging tests reveal abnormalities in the bone that require further investigation. The biopsy provides a tissue sample that can be analyzed to confirm a diagnosis, such as a bone infection, cancer, or other bone diseases, helping to guide treatment decisions.
Informed consent is a critical part of a CT-guided bone biopsy, ensuring that the patient understands the procedure, its risks, benefits, and any alternatives. It involves a discussion with the healthcare provider and documentation that the patient agrees to proceed with the biopsy after being fully informed.