Episode # 3 • 17 Jan 2025
Best Practices for Efficient Bone Marrow Biopsy Procedures
The very first episode of BackTable was about bone marrow biopsies, and the procedure has come a long way since. Powered drivers, smarter planning, and a well placed periosteal block have made it faster and far more comfortable for patients. On this episode of the BackTable Podcast, Dr. Mohammad Samim, a musculoskeletal radiologist at NYU Langone Health, joins host Dr. Chris Beck to discuss best practices for image-guided bone marrow aspiration and biopsy. They discuss how more referrals are coming from hematology, what drives the need for imaging guidance, and why a careful periosteal block lets most patients avoid sedation.
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Timestamps
00:00 - Introduction
03:31 - Referral Trends and Procedure Volume
06:15 - Indications and Contraindications
12:28 - Sedation and the Periosteal Block
16:30 - Procedure Walkthrough
23:13 - Powered Access and Variable Speed
29:43 - Sclerotic Bone and Dry Taps
34:55 - Aspiration Pain and On-Site Pathology
37:35 - Sternal Bone Marrow Aspiration
39:07 - Efficiency With Powered Systems
43:37 - Ultrasound Guidance and Workflow
46:45 - Hemodilution and Repeat Biopsies
48:14 - Closing Remarks
Resources
- Increasing Volume of Bone Marrow Biopsies by Radiology Providers: Evaluation of Trends by Physician Specialty and Practice Setting. J Am Coll Radiol. 2020
- BackTable Episode 1, the very first BackTable episode, on bone marrow biopsy, with Dr. Chris Beck, Dr. Aaron Fritts, and Anish Parikh
- Dr. Mohammad Samim, NYU Langone Health
- Dr. Chris Beck, BackTable contributor page
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More about this episode
The conversation then walks through the procedure itself, from reviewing pelvic anatomy and planning a trajectory on the scout to choosing between a single needle and a coaxial system and aiming for a core close to 1.5 centimeters. Dr. Samim explains how variable speed powered drivers work for both soft and sclerotic bone, what to do when a needle gets stuck or a tap comes back dry, and why a slow, steady pull makes the aspirate less painful. The episode closes with workflow tips for efficiency, minimizing hemodilution, and getting a high-quality sample the first time.
The Materials available on BackTable are provided for informational and educational purposes only and are not a substitute for the independent professional judgment of a qualified healthcare professional in diagnosing or treating patients. Any opinions, statements, or views expressed are those of the individual contributors and do not necessarily reflect those of the publisher, platform, or any affiliated organization.