MUSCULOSKELETAL BIOPSY: 10 Common questions and answers

1) Why are you here?

    Most patients come to The Johns Hopkins Musculoskeletal Department at the request of their doctor. In most cases your doctor will have received an imaging report (X-RAY, CAT SCAN, MRI) that has shown something out of the ordinary. Patients are sent to Johns Hopkins to take a small sample of the abnormality to figure out what it is. This will help your doctor to determine the best course of treatment.

2) What will happen when I get there?

   You will be greeted at the reception desk to fill out some paper work. Once that is done you will meet your nurse who will help you to get ready for the biopsy. Your nurse will talk to you about your medical history and any medicine you are taking. It is important to have a list of your medications with you. You will then meet the doctor who will perform the biopsy. That doctor will talk to you about what your exact biopsy will be like and be able to answer your questions.

3) What should I do to get ready for my biopsy?

   Each patient will receive an information packet in the mail with instructions on how to get ready for that biopsy. A few general tips are listed below.

- Can I eat before the biopsy? No eating or drinking is allowed after midnight. Sips of water while taking your pills is ok. If you are a diabetic and take medicine or insulin you will need to get some input from your general doctor. You should simply inform them that you will not be eating from midnight until after the biopsy and they will tell you how to change your medicine dose for that day.

- What medication can I take? In general you should take all your normal medication except for "blood thinners". A list of blood thinners and when to stop taking them will be a part of the packet you will get in the mail. This list tells you when to stop taking aspirin, Coumadin, or NSAIDS, which are common medications you may be taking that "thin" the blood.

-Do I need to get my blood drawn? Yes. It is important that anyone who is getting a biopsy have recent blood work to be sure everything is fine before you get here. This can be done at any lab but should be done 10 days before the biopsy and sent to your Johns Hopkins doctors office. That doctor should be the one who is sending you for the biopsy.

4) What will happen during the biopsy?

Each biopsy is done a little differently because each person will need to have their biopsy in a different place, but they all are done in basically the same way. You will be taken to the CT or CAT scan machine and you will lay flat on a table. The doctor you met earlier will take a picture of the place he/she is going to biopsy and clean that place with an antiseptic solution. The skin around the site will be covered with a sterile cloth to keep it clean and free of germs.

The nurse will give you some medicine to make you feel relaxed and comfortable and then the biopsy will begin. The doctor you met will use a very thin needle to numb up the place he is going to biopsy. You may feel a little pinch and burn when the thin needle goes in, but the medicine numbs any pain in a few seconds.

Once the skin is numb, the doctor will use a needle that is a little bigger to take a small piece of the mass to determine what it is. The doctor may have to take a few more pictures with the CAT scan machine to be sure the needle is in the right place. The number of pieces of the mass the doctor will take depends on your specific mass.

5) Will I need to do anything during the biopsy?

During the biopsy you will only need to lay still on the table. If you have back pain or joint pain that makes it difficult to lay still you should mention this to the doctor before you are taken into the biopsy room. The doctor can then make you as comfortable as possible before the biopsy starts.

6) Will it hurt?

Most people only feel minor discomfort from the small numbing needle. The numbing medicine will keep you from feeling pain at the biopsy site. The medicine the nurse puts in your IV will give you an overall feeling of comfort and take away some of your anxiety. If you feel excessive discomfort you can simply let the doctor know and he/she will give you more numbing medicine.

7) When will I know the results of my test?

On the day of the biopsy the doctor doing the biopsy will not be able to tell what the results are. The sample the doctor took goes to a special lab where it will undergo a series of tests to figure out exactly what it is.

8) How do I find out my results?

The person who will give you the results will be the same doctor who ordered your biopsy. It will typically take a few days to get the results, but for any questions about the results you can call the same doctor who ordered the biopsy.

9) Should I do anything special after the exam?

The nurse who is taking care of you will give you general instructions before you leave. If you feel discomfort after the procedure Tylenol is recommended, details like the dosage and how often to take it are printed on the discharge instructions you will get from your nurse.

10) Who should I call if I have a problem after the biopsy?

It is uncommon for a patient to have a problem after the biopsy. If you were to have a problem such as increasing redness or swelling at the biopsy site you should first call the radiologist that performed the biopsy. You may also call your regular doctor and inform them that you have had a recent biopsy. You should tell them the location of the biopsy and also what type of problem you are having. It would be helpful to keep your discharge paper work as that will give you and your doctor the details of what type of biopsy was done. They will be able to give you further instructions. If you are unable to contact your doctor you should visit your local ER. Again, you should bring your discharge paper work with you to help the ER doctors to better serve you.

Although no medical procedure is something patients look forward to, please be assured we will do all we can to make you experience as easy and comfortable as possible.