20240 Biopsy, bone, open; superficial (eg, sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)

Name of the Procedure:

Biopsy, Bone, Open; Superficial

• Common names: Bone Biopsy, Open Bone Biopsy
• Technical terms: Open Superficial Bone Biopsy

Summary

An open bone biopsy is a surgical procedure in which a small sample of bone tissue is removed for examination. This procedure typically targets superficial bones such as the sternum, spinous process, ribs, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, or phalanx.

Purpose

• Medical Condition Addressed: Designed to diagnose bone infections, tumors, or other bone abnormalities.
• Goals: Obtain bone tissue to analyze under a microscope to identify disease or infection, clarify unclear imaging results, or guide further treatment.

Indications

• Unexplained bone pain or swelling
• Suspected bone tumors (benign or malignant)
• Persistent infections suspected to involve bone tissue
• Abnormal imaging results requiring tissue confirmation
• Conditions where bone tissue pathology is necessary for diagnosis or treatment planning

Preparation

• Pre-Procedure Instructions: Patients may need to fast for a certain time before the procedure. Medication adjustments, especially blood thinners, may be necessary.
• Diagnostic Tests: Blood tests, imaging studies (X-rays, CT scans, MRIs), and a pre-procedure consultation to review medical history and current medications.

Procedure Description

1. Anesthesia: Local or general anesthesia is administered depending on the patient's condition and the biopsy site's accessibility.
2. Incision: A small incision is made over the bone site.
3. Bone Exposure: Surrounding soft tissue is carefully dissected to expose the bone.
4. Sample Collection: A special tool is used to remove a small sample of bone tissue.
5. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.
   • Tools/Equipment: Surgical scalpels, biopsy needles, forceps, bone chisels, and collection containers.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the complexity and location of the biopsy.

Setting

Usually performed in a hospital or a surgical center, either on an outpatient basis or as part of a hospital stay.

Personnel

• Orthopedic Surgeon or specialized surgical team
• Surgical nurses
• Anesthesiologist or nurse anesthetist (if general anesthesia is used)

Risks and Complications

• Common Risks: Pain at the biopsy site, infection, and bleeding.
• Rare Risks: Bone fracture, damage to surrounding tissues, adverse reactions to anesthesia, and poor wound healing.

Benefits

• Accurate diagnosis of bone conditions
• Helps determine the appropriate course of treatment
• Clarifies ambiguous imaging findings

Recovery

• Post-Procedure Care: Keep the biopsy site clean and dry, follow wound care instructions, and take prescribed medications for pain or infection prevention.
• Recovery Time: Generally, a few days to a week. Avoid heavy lifting and strenuous activities until the incision heals.
• Follow-Up: Appointments for suture removal and review of biopsy results.

Alternatives

• Needle Biopsy: Less invasive but might not be suitable for all locations or sufficient for diagnosis.
• Imaging Studies: Non-invasive but may not provide definitive tissue diagnosis.
• Watchful Waiting: Monitoring symptoms and imaging over time; may delay diagnosis and treatment.

Patient Experience

• During the Procedure: If local anesthesia is used, the patient will be awake but should not feel pain, only pressure. General anesthesia will mean the patient is asleep and unaware.
• After the Procedure: Some pain and discomfort at the biopsy site, manageable with prescribed pain relievers. Follow post-procedure care instructions closely to ensure proper healing.