A musculoskeletal biopsy is a procedure used to diagnose different diseases affecting your muscle tissues. If your healthcare provider suspects that you may have conditions like muscular dystrophy, myasthenia gravis, or trichinosis, they recommend you undergo a muscle biopsy. This procedure helps to determine the exact type and cause of the condition. A muscle biopsy involves the removal of cells and tissue from the muscle and sending them for testing in a lab.
Your doctor can use different techniques depending on the location of the muscle and the tests they need to perform. Although you may experience slight discomfort after the biopsy, this procedure is one of the most effective ways to diagnose severe muscle conditions. While the musculoskeletal biopsy is a less invasive surgical procedure, some complications could arise when it is not done professionally. Therefore, seeking expert advice and services is critical.
Overview of Musculoskeletal Biopsy
A muscle biopsy is a procedure where the doctor removes a small sample of your tissue for testing to diagnose different muscle diseases. When you visit your doctor with various symptoms that spell out muscle complications, the doctor could recommend a biopsy to help ascertain your exact condition and give directions on how to move forward with the treatment for your condition. Additionally, the doctor can use this procedure to rule out other conditions.
Since the procedure involves the removal of some tissues and cells, it is relatively simple and can be performed on an outpatient basis. There are two main ways through which a surgeon can perform a muscle biopsy:
Open Muscle Biopsy
An open biopsy involves cutting through the skin into the muscles to remove a part of the affected area. An open biopsy can be incisional or excisional. An open incisional biopsy removes a small amount of tissue. On the other hand, an open excisional biopsy involves the removal of a tumor in the muscles together with some parts of healthy cells. Often, the open excisional biopsy is more invasive and has more risks.
Needle Muscle Biopsy
The needle biopsy is the most common form of musculoskeletal biopsy. For this procedure, the doctor will insert a needle into your skin to remove part of the muscle. Depending on the specific location for the procedure, the doctor can use different types of needles, including:
- Fine needle aspiration. The fine needle aspiration biopsy involves using a thin needle connected to a syringe.
- Core needle biopsy. This kind of needle biopsy uses a broader needle with a hollow tube that allows extraction of the muscle cells.
- Image-guided needle biopsy. This type of needle biopsy uses x-rays or CT scans. Using the real-time image, the doctor can guide their needle to avoid damaging vital organs like the lungs or prostate.
- Vacuum-assisted needle biopsy. The vacuum-assisted core biopsy is a minimally invasive procedure that allows the removal of problematic muscle cells for testing. The surgeon makes a small incision in your skin and inserts a special biopsy needle. The doctor uses the vacuum instrument to suck out the cells. Mostly vacuum-assisted needle biopsy is an alternative to surgical biopsy.
Compared to open biopsy, a needle biopsy is more common for the following reasons:
- It results in little or no scarring on the skin
- The procedure is quick
- Fat recovery
Eligibility for Musculoskeletal Biopsy
You are a good candidate for a biopsy if your doctor suspects some abnormalities in your muscles. Various diseases and conditions can cause pain and weakness in your muscles. However, it is challenging for the doctor to determine the exact condition with the symptoms. A biopsy, in this case, will help determine the source and extent of the disease for proper treatment. Some of the common conditions diagnosed through muscle biopsy include:
Muscular Dystrophy
Muscular dystrophy is a term used to describe the various inherited diseases of the muscles that control the movement of different body parts. There are several types of muscular dystrophy, with the most common ones being:
- Duchene MD. The DMD is a common form of muscular dystrophy affecting males
- Becker MD. Like DMD, Becker's muscular dystrophy is more common, with its symptoms appearing later in life
- Myotonic muscular dystrophy. MMD is common in males and females and can arise from childhood to adulthood.
- Congenital muscular dystrophy. Congenital means that the complication begins at birth and can progress as you enter adulthood.
Some of the common symptoms that could spell out muscular dystrophy include:
- Trouble jumping or running
- Frequent falls
- Waddling gait
- Delayed growth
- Muscle stiffness and pain
Since MD shares symptoms with other conditions, your doctor may need to perform a biopsy to ensure you receive treatment for the right condition.
Polymyositis
Polymyositis is a condition that causes muscle inflammation and weakness. Often this condition affects individuals between thirty to fifty years. Although the exact cause of this condition is unknown, polymyositis is associated with autoimmune conditions. The main characteristic of polymyositis that could cause your doctor to recommend a musculoskeletal biopsy is the weakness in the hip, thigh, shoulder, and neck muscles.
When left untreated, polymyositis can result in these complications:
- Aspiration pneumonia. This condition causes difficulty swallowing and can result in breathing food particles into the lungs.
- Difficulty swallowing. When polymyositis affects the neck muscles, you may experience difficulty swallowing, resulting in weight loss.
- Breathing complications. For individuals experiencing weakness of chest muscles, shortness of breath, or severe respiratory failure is common.
Performing a biopsy on the area experiencing muscle weakness is essential in diagnosing Polymyositis and ensuring proper treatment to avoid life-threatening complications.
Myasthenia Gravis
Myasthenia gravis is an autoimmune disorder where the antibodies destroy the neuromuscular connections in the body. The destruction affects muscle and nerve communications. Muscle weakness is a common symptom of MG and is experienced with prolonged muscle use. Although myasthenia gravis affects multiple areas, some muscles are affected more than others.
When the condition affects your eyes, you could experience a dropping of the eyelids or double vision. In a high percentage of individuals suffering from MG, muscle weakness occurs in the face and throat. Myasthenia gravis on the face is characterized by:
- Inability to speak properly
- Difficulties chewing and swallowing
- Change in facial expression
When you visit your doctor with symptoms such as difficulty breathing or holding your head up, the doctor may recommend a muscle biopsy.
Friedreich’s Ataxia
Friedreich’s ataxia is a genetically inherited muscle disorder that affects balance and coordination. This condition damages the cerebellum portion of your brain, the spinal cord, and peripheral nerves. Friedreich’s ataxia often develops in childhood and worsens in teen years and adulthood. Some of the common symptoms of Friedreich’s ataxia include:
- Excessive fatigue
- Trouble walking
- Loss of sensation in the arms, feet, and trunk
- Hearing loss
- Vision difficulties
- Heart palpitations
- Chest pain
The symptoms of Friedreich’s ataxia could result from muscle damage or heart disease that develops in individuals with this condition. If the blood tests and observations of reflexes do not give a conclusive diagnosis, your doctor could recommend a muscle biopsy.
Preparation for Musculoskeletal Biopsy
The decision to undergo a muscle biopsy is not made lightly. After visiting your doctor with symptoms that indicate a possible muscle complication, the doctor will assess you and may recommend a muscle biopsy to ascertain the exact condition. If you agree to the biopsy, you can prepare for the procedure in the following ways:
- Ask about the procedure. You may not know the process if it is your first time undergoing a biopsy. You need to ask any questions you may have about the process and its outcome before the date of your procedure. A professional healthcare provider must be truthful about the procedure and allow you to make an informed decision.
- Sign consent for the procedure. Like other surgical procedures, a muscle biopsy can have several complications. Therefore, you must carefully read and understand the consent form before committing to the process.
- Medical history. The doctor will perform a physical exam to ensure you are in good health to undergo the procedure. You must disclose all your medical conditions before the procedure during your medical examination. For example, if you are allergic to anesthesia or have a medical condition affecting your blood’s ability to clot, you must disclose this to avoid unforeseen complications.
- Inform your healthcare provider of conditions such as pregnancy and other medications you might be taking.
- The doctor could ask you to fast for some hours before the procedure
- Your healthcare provider could request other preparations depending on your health and specific condition.
Musculoskeletal Biopsy Procedures
A musculoskeletal biopsy is an outpatient procedure. Therefore, you may not need to spend the night in the hospital. When you have understood what the process entails, and the doctor determines that it is safe to move forward, a procedure date is scheduled. A muscle biopsy is done in the following steps:
- Cleaning of the biopsy site. The skin is prone to various bacteria that could cause infection in the biopsy wound. Therefore, the doctor will clean the area with an antiseptic before the procedure.
- Injection of anesthesia. The doctor will numb the area of the procedure by injecting local anesthesia. Since the procedure is minimally invasive, you will not need general anesthesia.
- Collection of the sample. Since needle biopsy is the most common muscle biopsy method, the surgeon will insert the needle into the muscle through the skin and take some cells. Due to the local anesthesia, you will not feel any pain throughout the procedure. If a larger sample is needed for multiple tests, the doctor may make a small incision on the skin surface to allow the removal of more cells.
- Needle withdrawal. After the sample is collected, the doctor will remove the needle and press the biopsy site to stop the The level of bleeding you experience from a muscle biopsy site varies depending on the size of the incision and the sample removed.
- Closing of the biopsy site. Depending on the size of the incision or wound, your healthcare provider will use stitches or adhesive strips to close the incision. Additionally, they may put a bandage over the area to protect it from germs.
Complications Associated with Musculoskeletal Biopsy
Although muscle biopsy is a simple and less invasive procedure, any procedure that involves breaking the skin carries some risk. Some of the complications that may arise from a muscle biopsy include:
- Bruising. When you bump into something hard, or someone hits you, blood vessels on your skin could break, causing minor bleeding. Since biopsy involves breaking the skin, you may experience some bruising from the area around the incision. You can ease the bruising from a muscle biopsy by applying an ice pack at the site for ten to fifteen minutes within 24 or 48 hours of the procedure.
- Pain around the biopsy site. During a musculoskeletal biopsy, your surgeon will apply anesthesia. Therefore, you may not experience any pain during the procedure. However, when the anesthesia wears off, you can experience pain and discomfort on and around the site. When the doctor discharges you, they could prescribe some pain medication.
- Bleeding from the biopsy site. Since a musculoskeletal biopsy involves breaking through the skin and removing a piece of tissue for testing, you may experience bleeding from the site. However, the bleeding should stop when you apply pressure to the area. You should seek immediate care if the bleeding is excessive or does not stop.
- Infection. The human body is constantly exposed to microorganisms from the environment and those residing inside the body. When the tissues around the incision are exposed to bacteria, you could suffer an infection at the biopsy site. An infection at the biopsy site or some of the most severe complications you can suffer from the surgery. You should look for signs of infection after your biopsy, including fever, swelling, redness, and pus from the area.
Discharge Instructions for a Musculoskeletal Biopsy
A muscle biopsy procedure is not very invasive. The main aim of the process is to diagnose different muscle conditions and not treat them. However, your doctor can give you the following instructions that you must follow after the procedure to avoid complications:
- Remove the bandage covering the incision area within twenty-four hours of the procedure
- Until you return for an appointment for the removal of stitches, you should not remove the adhesive strips. Sometimes, the surgeon can use absorbable stitches or glue to cover the area. In this case, you will not need to return for the removal of stitches.
- You must replace any adhesive strips that fall off to avoid prolonged exposure to the incision site.
- Keep the area dry. Before your wound heals, you should take sponge baths to avoid wetting the incision site.
- You shouldn’t panic about redness, swelling, or small rims around the biopsy.
- If you experience pain that needs medication, you should avoid aspirin. Instead, you can take other pain relievers.
- If you need the removal of stitches, you must make a follow-up appointment within ten to fourteen days following the biopsy.
The healing process is fast when the procedure is performed by a skilled professional and in a sanitary environment. However, if you experience any of the following symptoms. You must seek immediate medical care:
- Increased redness on or around the incision site
- Pain swelling and discomfort
- Pus or drainage from the biopsy site
- Uncontrolled bleeding from the wound
- Fever. Fever after surgical procedures is a significant sign of infection and should never be ignored.
The outcome of Musculoskeletal Biopsy
Once the doctor collects the necessary sample, the biopsy ends. Your doctor will then send this sample to a laboratory for testing. The requirement takes a short time, but the duration will depend on your condition. Although the musculoskeletal biopsy is an outpatient procedure, you may need to remain for observation depending on your reaction and the procedure's outcome.
A pathologist will study your sample and create a pathology report, which could include:
- A description of your biopsy sample
- A diagnosis of muscle diseases
The results of your biopsy sample testing will dictate how the doctor moves forward with treating your underlying muscle condition.
Find Top-Notch MRI and Treatment Services Near Me
If you experience symptoms like muscle weakness and your doctor suspects an infection or disease of the muscles, they could recommend a muscle biopsy. A musculoskeletal biopsy is a minimally invasive procedure involving the insertion of needles to remove muscle tissues and test them for abnormalities. Depending on your symptoms and the disease your doctor wishes to diagnose or rule out, you can undergo an open or needle muscle biopsy. Common muscle conditions for which your doctor could recommend a muscle biopsy to diagnose include muscular dystrophy, trichinosis, and myasthenia gravis.
While the muscular biopsy is not a treatment procedure, the outcome can positively or negatively affect your health. The most positive effect of the muscle biopsy is a diagnosis that guides the treatment of your condition. However, the procedure can result in complications like excessive bleeding and infections. Therefore, you must consult with a skilled healthcare provider. At Hollywood Healthcare & Diagnostic Imaging, we offer accurate diagnosis and treatment services for our clients in Los Angeles, CA. Contact us today at 323-486-7502.
