Bone biopsy

Bone biopsy

Bone biopsy involves the removal of a small core of bone, approximately 7mm wide, from the ‘hip’ otherwise known as the pelvic bone through a small cut in the skin. It is being performed to provide a diagnosis so that the right treatment can be given. The test is performed in the Day Unit in Ely Hospital or Addenbrooke’s Hospital and takes approximately 15 to 30 minutes. You will need to fast for four hours before the procedure (no eating or drinking).

Before your procedure

• Most patients attend a pre-admission clinic.
• At this clinic, you will be asked about your medical history and carry out any necessary clinical examinations and investigations. This is a good opportunity for you to ask us any questions about the procedure, please feel free to discuss any concerns you might have at any time.
• You will be asked if you are taking any tablets or other types of medication – these might be ones prescribed by a doctor or bought over the counter in a pharmacy. It helps us if you bring details with you of anything you are taking (for example: bring the packaging with you).
• Most people who have this type of procedure will need to stay in hospital for approximately two to four hours.
• No tests are routinely required before the biopsy although it may be necessary in some cases to check your blood clotting. There is no need to change your diet or fast before you arrive for the biopsy.

Oxytetracycline 250 mg

It is necessary to take these tablets, before the bone biopsy for technical reasons. They are taken up by the bone and act as markers of bone mineralisation giving valuable information. Please read the label on the outside of the bottle and observe the following:

• If you are allergic to tetracycline do not take them.
• If you develop a skin rash stop taking the tablets immediately and avoid direct exposure to sunlight, as this may make the rash worse.

Please follow carefully the instructions below: -

Take one tablet twice a day on the following four days.
Day 1 .........................................................................................................................................
Day 2 .........................................................................................................................................

Then leave a ten day gap

Day 3 .........................................................................................................................................

Day 4 .........................................................................................................................................

Please note that there is a 10-day gap between the second and third days.

You should thus take eight tablets in total.

If you have any queries, please contact the metabolic bone nurse on 01223 254933 option 2, then option 2.

During the procedure

• An injection of a mild, short acting sedative and painkiller is given into a vein in the arm or hand through a small needle before the biopsy is taken. You may feel a little sick or drowsy for a few hours after the procedure.
• While you are sedated, the doctor will inject local anaesthetic into the site that the biopsy is taken from to reduce pain during and after the procedure.

After the procedure

• There may be one or two stitches in the skin afterwards. Usually these will dissolve; sometimes however they need to be removed 7 to 10 days after the biopsy and we will let you know if this is the case. There may be some soreness around the site of the biopsy after the local anaesthetic wears off but this is generally mild and usually only lasts for 24 hours or less. If required, a pain relief drug such as Paracetamol or Nurofen may be taken.
• Because of the sedative given before the biopsy, you will not be able to drive a car for the rest of the day and we will ask you to arrange for a friend or relative to take you home after the biopsy. The examination may be cancelled if you come without someone who will accompany you home. We will also advise you to rest as much as possible for the rest of the day.

Special measures you need to take after the procedure:

• Do not return to work the same day following biopsy. Go home and rest. You should be able to return to work the day after the biopsy.
• Do not operate any machinery for 24 hours following the procedure.
• Please do not drive your car for 24 hours following the biopsy.
• Do not drink any alcohol for 24 hours following the procedure. Keep the applied pressure dressing on for 24 hours.
• Keep the wound clean and dry.

Check-ups and results

• Take letter to GP.
• We will let you know if you have non-dissolvable stitches. If so you will be asked to make an appointment to see your GP seven to ten days following the biopsy to have the biopsy site stitches removed.

Alternative procedures that are available

• There are no alternative procedures to provide the diagnosis.

Serious or frequently occurring risks

• Bone biopsy is a very safe procedure and has no serious side–effects. Mild bruising occurs in approximately 1 in every 200 patients. Before the biopsy you will be asked to take some tablets, which are taken for technical reasons for the biopsy and should not affect you in any way unless you are allergic to tetracycline.
• If you develop a skin rash or diarrhoea while taking the tablets, you should stop them immediately.

Information and support

Please note, should you experience any problems following the bone biopsy or you are worried about anything, please contact either the Consultant Metabolic Bone Physician on telephone 01223 245151 ext 2774 or the metabolic bone nurse on 01223 254933 option 2, then option 2.

Local anaesthesia

The local anaesthetic drug is injected into the skin and tissues at the site of the operation. The area of numbness will be restricted and some sensation of pressure may be present, but there should be no pain. Local anaesthesia is used for minor operations such as stitching a cut, but may also be injected around the surgical site to help with pain relief. Usually a local anaesthetic will be given by the doctor doing the operation.

Sedation

Sedation is the use of small amounts of anaesthetic or similar drugs to produce a ‘sleepy-like’ state. Sedation may be used as well as a local or regional anaesthetic. The anaesthesia prevents you from feeling pain, the sedation makes you drowsy. Sedation also makes you physically and mentally relaxed during an investigation or procedure which may be unpleasant or painful (such as an endoscopy) but where your cooperation is needed. You may remember a little about what happened but often you will remember nothing.

Risks associated with a local anaesthetic:

• Local anaesthetics are very safe.
• As for all injections, sometimes you will get some bruising, minor bleeding or soreness where you have had the injection, but this usually goes away within hours to days. If the area becomes red, inflamed and swollen after a few days, then you should contact your GP for advice.
• Very rarely people have an allergic reaction to the local anaesthetic medicine itself but this usually happens quickly and can be treated. To prevent avoidable allergic reactions, you will be asked before your procedure about any previous reactions to local anaesthetics.

Privacy & Dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.