• Surgical biopsy to obtain samples of bone for diagnostic histopathology or culture and sensitivity studies.

Uses

• In the investigation of bone diseases or radiological abnormalities where the underlying etiology is uncertain.
• To determine suitable antibiotic choice in osteomyelitis .

Advantages

• Good quality samples should permit accurate histological diagnosis and therefore provide valuable information on prognosis and rational treatment options.
• Culture of infected bone should provide a reliable guide as to the pathogens involved in osteomyelitis .

Disadvantages

• May be difficult to obtain diagnostic sample by percutaneous biopsy.
• Fracture at the biopsy site occasionally occurs if a large sample is removed from already weakened bone.

Alternative techniques

• Infected fracture sites may be swabbed rather than biopsied, but practically, it is easy to retrieve bone fragments for culture during fracture repair.

Time required

Preparation

• 10 min.

Procedure

• 20-30 min.

Decision taking

Criteria for choosing test

• Ensure a representative area of bone is biopsied: careful study of the radiographs helps.
• Aim to biopsy from the center of the lesion(s).

Risk assessment

• In suspect neoplastic diseases, thoracic radiographs Radiography: thorax should be evaluated as this may dictate the extent of investigation, ie there is little point in taking biopsies from animals with clear signs of pulmonary metastasis already present.
  Inflated left and right lateral views and a ventrodorsal view are the most sensitive radiological techniques in investigating the chest for neoplastic secondary tumors. A single view risks overlooking lesions.