The tactics and technique of musculoskeletal biopsy

Abstract

▪ The treatment of musculoskeletal neoplasms and infection is usually based on an initial diagnostic biopsy. ▪ Prior to biopsy, a hypothesis should be formed about the most likely diagnosis and a differential diagnosis. These deliberations should consider whether the lesion is a primary benign or malignant tumour, a metastasis, a haematological problem or an infection. ▪ A tactical plan should be developed which evaluates the necessity, the risk, the approach and finally defines the technique of biopsy most likely to achieve a representative result in the clinical case. ▪ In developing this technical approach, the pitfalls should be anticipated, i.e. inadequate sampling, difficulty of pathological interpretation and contamination. ▪ The tactical approach should be developed in conjunction with a multi-disciplinary team together with appropriate pre-biopsy imaging.