Article
Bone Marrow Biopsy Procedure
Dr. Chris Beck • Updated Jan 2, 2024
The bone marrow biopsy procedure is a minimally invasive technique used to evaluate bone marrow health and diagnose conditions such as leukemia, lymphoma, anemia, or other blood-related disorders. Performed under local anesthesia, this procedure involves extracting a small sample of bone marrow, typically from the hip bone, for detailed laboratory analysis. It is an essential diagnostic tool that helps healthcare providers understand the cause of abnormal blood counts and develop targeted treatment plans. The bone marrow biopsy procedure is a safe and effective method, offering critical insights into hematologic health while ensuring patient comfort throughout the process.
Table of Contents
Pre-Procedure Prep
Bone Marrow Biopsy Procedure Steps
Post Bone Marrow Biopsy Care
Pre-Procedure Prep
Bone Marrow Biopsy Indications
• Hematologic disorders such as leukemia, lymphoma, multiple myeloma, anemia, etc.
Contraindications
• Few if any
• A bone marrow biopsy procedure can be performed in setting of thrombocytopenia
• Cellulitis at skin entry site or underlying soft tissue infection should prompt evaluation for different site
Pre-Procedural Evaluation
• H&P
• Prior imaging cross sectional imaging of the pelvis
Featured Podcast
Episode # 1 • 08 Apr 2017
BM BX Devices: Jamshidi vs. OnControl
Listen to New Orleans IR Christopher Beck MD and Dallas IR Aaron Fritts MD discuss preferences in bone biopsy needles.
Bone Marrow Biopsy Procedure Steps
Site
• Most common site for a bone marrow biopsy procedure is iliac wing.
CT Guided Bone Marrow Biopsy
• Prone patient with posterior approach
• Advance needle along length of the iliac wing.
• For right iliac wing biopsy, operator stands on patient's left and skin entry site is midline with lateral trajectory
• Seat needle just beyond cortex. Occasionally, helpful to have mallet to assist with seating the needle beyond the cortex
• Remove inner stylet. Aspirate with large volume syringe (20 - 30 mL)
• Following aspiration, advance biopsy device without inner stylet into iliac wing 2-3 cm,
• Can be helpful to gently rock biopsy device to help capture specimen. Many devices have additional tools to assist with specimen capture
Following Successful Aspirate and Bone Biopsy
• Hemostasis with compression
• Apply sterile dressing
• Option to take final pictures confirming no immediate post operative complication
Post Bone Marrow Biopsy Care
Bone Marrow Biopsy Complications
• Rare
• Bleeding is most common
• Injury to surround structures
• Patient's can be sore 2-3 days following procedure
• Inadequate sample
Bone Marrow Biopsy Recovery Time
• 15 minutes bedrest if local only
• Often times, moderate sedation will necessitate more recovery time than actual biopsy
Additional resources
[1] Cohen MG, McMahon CJ, Kung JW, Wu JS. Comparison of Battery-Powered and Manual Bone Biopsy Systems for Core Needle Biopsy of Sclerotic Bone Lesions. AJR Am J Roentgenol. 2016;206(5):W83‐W86. doi:10.2214/AJR.15.15067
[2] Lee RK, Ng AW, Griffith JF. CT-guided bone biopsy with a battery-powered drill system: preliminary results. AJR Am J Roentgenol. 2013;201(5):1093‐1095. doi:10.2214/AJR.12.10521
[3] BackTable, LLC (Producer). (2017, April 14). Ep 1 - BM BX Devices: Jamshidi vs OnControl [Audio podcast]. Retrieved from https://www.backtable.com/shows/vi
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