对于足部和踝关节感染的患者，进行骨活检（方法、部位、影像学使用）的最佳方法是什么？

What Is the Optimal Method to Perform Bone Biopsy (Method, Location, Imaging Use) for Patients With Foot and Ankle Infections?

机构信息

1 Rothman Orthopaedics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.

出版信息

Foot Ankle Int. 2019 Jul;40(1_suppl):38S-39S. doi: 10.1177/1071100719859888.

DOI:10.1177/1071100719859888

PMID:31322943

Abstract

RECOMMENDATION

A bone biopsy should generally be performed in a percutaneous fashion, particularly in cases where surgical debridement is not considered necessary. If surgical debridement is considered necessary, then an open biopsy can be performed as part of the debridement. Percutaneous biopsy should be performed under sterile conditions by an interventional radiologist or other physician trained in image-guided techniques. The location of the biopsy will depend upon the clinical and radiographic evaluations, with a goal of maximizing the yield of the biopsy while minimizing the risk of injury to surrounding and/or overlying soft tissue structures.

LEVEL OF EVIDENCE

Consensus.

DELEGATE VOTE

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus).

摘要

建议

一般应采用经皮方式进行骨活检，尤其是在不需要考虑手术清创的情况下。如果认为有必要进行手术清创，可作为清创的一部分进行开放式活检。经皮活检应由介入放射科医生或其他接受过影像引导技术培训的医生在无菌条件下进行。活检的位置将取决于临床和影像学评估，目的是在最大程度提高活检产量的同时，将对周围和/或覆盖的软组织结构造成损伤的风险降到最低。