Paper of the week: Percutaneous CT guided bone biopsy for suspected osteomyelitis: Diagnostic yield and impact on patient’s treatment change and recovery. Hoang D, Fisher S, Oz OK, La Fontaine J, Chhabra A. Eur J Radiol. 2019 May;114:85-91. doi: 10.1016/j.ejrad.2019.01.032.
Summary by Dr. Sreeram Penna
This retrospective audit was done to assess the utility of CT guided bone biopsy for suspected osteomyelitis. 115 patients were included in the study. Of these 40 patients had systemic symptoms of toxemia while 75 had only localized symptoms at the time of presentation. The most common bone biopsy site was the sacrum/ischium (49), followed by the spine (35), extremities (32), and the chest wall (2). Upon culture of the biopsy sample, only 24 were positive (21%). Of these positive cultures, 19 out of 24 have grown different organism compared to blood cultures. Common organism grown in biopsy cultures were Staphylococcus aureus (29.2%) followed by Escherichia coli (12.5%). Of the biopsies taken only 36 had histology performed. Of these 11 (30.6%) showed evidence of inflammation or osteomyelitis, 12 (33.3%) showed no evidence and 13 (38.1%) were inconclusive. In conclusion, this study shows a low yield of positive cultures or histology following bone biopsy for osteomyelitis.