Bone Marrow Biopsies

what are the indications for a bone marrow biopsy?

-unexplained cytopenia

-abnormal peripheral smear findings

-hematologic malignancy workup & staging

what are the absolute contraindications for a bone marrow biopsy?

-hemophilia

-severe DIC

-severe bleeding disorder

what are the relative contraindications for a bone marrow biopsy?

-skin infection near site

-osteomyelitis near site

-uncooperative patient

-myeloma

what is the preferred site for a bone marrow biopsy?

-posterior superior iliac crest

what are the alternative sites for a bone marrow biopsy?

-anterior iliac crest

-sternum

-ribs

-vertebrae

-femur

which alternate bone marrow biopsy site can ONLY be aspirated?

-sternum

which bone marrow biopsy site is used for infants?

-femur

what type of needle is needed for a bone marrow core biopsy?

-Jamshidi biopsy needle

what are the anatomic landmarks for the preferred bone marrow biopsy site?

-3 fingerbreadths lateral to midline

-2 fingerbreadths below iliac crest

what are the post-procedure instructions for a bone marrow biopsy?

-apply pressure until bleeding contained → apply sterile dressing

-keep patient supine for > 10min

-monitor for bleeding

what are possible complications of a bone marrow biopsy?

-bleeding

-local infection

-neuropathy, osteomyelitis, needle breakage