A bone biopsy is a procedure to take a sample of bone tissue for examination under a microscope. It is performed to diagnose bone lesions, tumours, infections, or other conditions that cannot be conclusively identified through imaging alone.
A biopsy can be performed as a needle biopsy (using a special needle inserted through the skin under X-ray or CT guidance) or as an open biopsy (through a small surgical incision). The sample is sent to the laboratory for analysis. Needle biopsy takes 30–60 minutes; open biopsy takes approximately one hour.
Biopsy is essential for diagnosing bone tumours (benign or malignant), suspected bone infection (osteomyelitis), unexplained bone lesions seen on imaging, and metabolic bone diseases when the diagnosis is uncertain.
In some cases, imaging (MRI, CT, bone scan, PET-CT) may be sufficient for diagnosis. However, definitive tissue diagnosis often requires a biopsy, particularly when malignancy is a possibility.
Blood tests including clotting studies. The biopsy site and approach are carefully planned to avoid contaminating uninvolved tissue compartments, as this is critical if further surgery is needed.
Definitive tissue diagnosis that guides treatment. This information is essential for planning surgery, chemotherapy, radiotherapy, or antibiotic treatment.
Soreness at the biopsy site for several days.
Local bruising.
The biopsy may not provide enough tissue for a definitive diagnosis, requiring a repeat procedure.
Risk of introducing infection, particularly into bone.
Weakening of the bone at the biopsy site, potentially causing a pathological fracture.
Significant bleeding from the biopsy site.
Damage to structures near the biopsy site.
Very rare spread of tumour cells along the biopsy tract. Careful technique minimises this risk.
Needle biopsy: usually local anaesthesia with sedation. Open biopsy: general or regional anaesthesia.
For needle biopsy: a dressing over the puncture site, rest for 24 hours, and avoid heavy loading of the area for a few days. For open biopsy: a wound dressing, stitches removed at 10–14 days, and activity restrictions depending on the location and findings.
Results are typically available within one to two weeks. A follow-up appointment to discuss results and plan treatment is arranged.
The biopsy tract must be placed so that it can be removed during any subsequent surgery. Poorly placed biopsies can complicate definitive treatment. This is why biopsies of suspected tumours should be performed at or in consultation with a specialist tumour centre.
Preliminary results may be available within a few days. Definitive diagnosis, including special stains and molecular testing, may take one to two weeks.