A test in which a piece of bone or bone marrow is removed for examination.

A bone biopsy involves removal of a small piece of bone for examination. A special drill needle is usually used. A local anesthetic is given, a small (about 1/8-inch) incision is made in the skin, and the biopsy needle is pushed and twisted into the bone.

Once the sample is obtained, the needle is twisted out and the sample is sent for examination. Pressure is applied to the site. Once bleeding stops, the site is cleaned and covered with a bandage.

Bone biopsy may also be performed under general anesthesia as a surgical excision (cutting out) of a piece of bone. Excision provides a larger specimen and may permit immediate surgical removal if examination indicates a malignant (cancerous) tumor.

You may be asked to fast before a bone biopsy. If it is to be performed under general anesthesia, fasting for 6 to 8 hours is recommended. You must sign a consent form.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:

• infant test or procedure preparation (birth to 1 year)
• toddler test or procedure preparation (1 to 3 years)
• preschooler test or procedure preparation (3 to 6 years)
• schoolage test or procedure preparation (6 to 12 years)
• adolescent test or procedure preparation (12 to 18 years)

You may feel moderate discomfort and pressure, even though a local anesthetic is used for a needle biopsy. You must remain still during the procedure.

After the biopsy, the area may be sore or tender for several days.

The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone tumors, and to identify other bone abnormalities. It may be performed on people with bone pain and tenderness, particularly if X-ray, CT scan, or other testing reveals a mass (aggregation of cells) or abnormality.

Normal bone appears as 2 types: compact and cancellous. Compact bone is dense and contains concentric layers of mineral deposits (lamellae). Cancellous bone looks porous, with widely spaced lamellae, and red and yellow marrow in the center of the bone.

Benignbone tumors include:

• osteoid osteoma
• osteoblastoma
• bone cyst
• fibroma

Malignant tumors include:

• multiple myeloma
• osteosarcoma
• Ewing's sarcoma

Other conditions include:

• osteomalacia
• osteitis fibrosa
• infection (osteitis) associated with:
  • histoplasmosis
  • Coccidiomycosis
  • mycobacteria

Additional conditions under which the test may be performed:

• osteomyelitis
• rickets

• discomfort
• bone fracture
• damage to surrounding tissue
• infection, localized (a risk any time the skin is broken)
• infection of the bone (osteomyelitis)
• excessive bleeding

Note: Some people with bone disorders also have blood coagulation disorders, so the bleeding risk may be higher for some people than for others.

Signs of bone infection (one of the most serious risks) include fever, headache, pain with movement, redness and swelling of the tissues around the biopsy site, and drainage of pus from the biopsy site.