A bone biopsy is a procedure in which a small sample of bone is taken from the body and looked at under a microscope for cancer, infection, or other bone disorders. The sample of bone can be removed by:

• Inserting a needle through the skin and directly into the bone (closed, needle, or drill biopsy). A numbing medicine (local anesthetic) is used to prevent pain during this procedure. Intravenous (IV) pain medicine and a sedative medicine also may be given.
• Making a cut (incision) through the skin to expose an area of the bone (open biopsy). General anesthesia or medicine to block feeling in the area where the cut is made (spinal anesthesia or a nerve block) is given for this procedure.

A bone biopsy can be taken from any bone in the body. It is easiest to get the biopsy samples from bones that are close to the skin surface and away from any internal organs or large blood vessels.

A bone biopsy is often done on bone areas that show problems on an X-ray. Computed tomography (CT scan) or a bone scan may be used to guide the biopsy needle.

Why It Is Done

A bone biopsy is done to:

• Confirm the diagnosis of a bone disorder (such as Paget's disease, a disease that may look like bone cancer, or bone cancer) that was found by another test, such as an X-ray, CT scan, bone scan, or a magnetic resonance imaging (MRI) scan.
• Tell the difference between a noncancerous (benign) bone mass, such as a bone cyst, and bone cancer, such as multiple myeloma.
• See what is causing a bone infection (osteomyelitis) or if an infection is present.
• Find the cause of ongoing bone pain.
• Check bone problems seen on an X-ray.

An open bone biopsy allows your doctor to do surgical treatment at the same time, if needed.

How To Prepare

Before having a bone biopsy, tell your doctor if you:

• Are taking any medicines. If you take medicines every day, ask your doctor whether you should take these medicines on the day of the biopsy.
• Are allergic to any medicines, such as those used to numb the skin (anesthetics).
• Have had bleeding problems or take blood thinners, such as aspirin or warfarin (Coumadin).
• Are or might be pregnant.
• Take any herbal remedies. Some of these remedies may thin the blood.

Getting ready for a bone biopsy changes depending on the type of biopsy that will be done.

• For a closed biopsy (needle biopsy), you do not need to do anything before the procedure. Right before the procedure, you will be asked to remove most or all of your clothes. You will be given a gown to use. You will be awake during the procedure. Arrange to have someone drive you home because you may get a medicine (sedative) to help you relax.
• For an open biopsy, do not eat or drink anything for 12 hours before the biopsy. You can eat your regular diet after the procedure. You may need to stay overnight in the hospital after an open biopsy is done.

Before a bone biopsy, you need to sign a form (consent form) that says you understand the risks of the bone biopsy and agree to have the procedure done. Make sure that you understand how this procedure is done before signing the consent form. Talk to your doctor about any concerns you have regarding the need for the biopsy, its risks, how it will be done, or what the results will mean. To help you understand the importance of this procedure, fill out the medical test information form(What is a PDF document?).