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Percutaneous Needle Technique Musculoskeletal Biopsy

Background

Percutaneous image-guided musculoskeletal biopsy provides an accurate, rapid, and cost-effective method for helping clinicians diagnose benign and malignant musculoskeletal lesions.
In patients who present with nonspecific physical findings, imaging studies, and laboratory values, percutaneous biopsy can lead to a rapid and accurate diagnosis and allow implementation of the most appropriate therapy. Most biopsies can be performed using local anesthesia, with the addition of conscious sedation if necessary.

Various imaging modalities can be used to target the lesion, including computed tomography (CT), fluoroscopy,
ultrasonography (US), and magnetic resonance imaging (MRI). The procedure is safe, with major complications uncommonly reported. When proper techniques are used, nondiagnostic or insufficient specimens are obtained in only approximately 8-10% of biopsies. Accuracy is expected to be 70-100% and is improved with expert cytopathologic interpretation.

A 2009 review of 309 biopsies noted that image-guided core needle biopsy was particularly effective in diagnosing homogenous soft-tissue tumors.
Rimondi et al also noted the reliability of percutaneous CT-guided biopsy after analyzing 2027 cases over a period of 18 years.

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