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Complications associated with improper palpation-guided iliac bone marrow biopsy tracts identified on follow-up imaging

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Abstract

Objective

Bone marrow biopsy complications are rare. Our aim is to study the association of improper palpation-guided iliac biopsy tract with complications.

Materials and methods

This is a retrospective study of adult patients who underwent iliac bone marrow biopsy without image guidance at our hospital from January 2019 to January 2021, and have cross-sectional radiologic imaging of the pelvis within 30 days following the procedure. Electronic health records were reviewed for clinical data. Two radiologists reviewed images of the pelvis for assessment of biopsy tract and complications.

Results

A total of 443 procedures were included in 309 patients, mean age 53.4 ± 18.1 years, 112 females (36.2%). In addition, 332 tracts were proper (75%), 97 improper (22%), and 14 unidentified (3%). All 11 complications occurred in procedures with improper tracts; nine bleeding, one fracture, and one facet joint injury. Improper tract was significantly associated with complications (p < .001). There was no statistically significant association between platelet count, international normalized ratio, antiplatelet use and anticoagulant use, and presence of complications (p > .05). Body mass index and subcutaneous fat thickness overlying posterior superior iliac spine were not associated with improper tract (p > .05). Procedures performed by providers with ≤ 12 months’ experience were significantly associated with improper tract (p < .001) and hence associated with complications (p = .007).

Conclusion

Improper tracts were common in palpation-guided iliac bone marrow biopsy and significantly associated with complications. No complications were encountered in proper tract procedures. Procedures performed by providers with ≤ 12 months’ experience were significantly associated with improper tract and complications.

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Acknowledgements

The authors would like to thank Dahlia Saab for her help in statistical analysis.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020, PO Box 11-0236, Beirut, Lebanon

    Mihran Khdhir, Yara Jabbour, Caline Azzi, Raquelle El-Alam, Nadim Muallem & Hicham Moukaddam

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  1. Mihran Khdhir
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  2. Yara Jabbour
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  3. Caline Azzi
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  4. Raquelle El-Alam
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  5. Nadim Muallem
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Correspondence to Mihran Khdhir.

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Khdhir, M., Jabbour, Y., Azzi, C. et al. Complications associated with improper palpation-guided iliac bone marrow biopsy tracts identified on follow-up imaging. Skeletal Radiol 51, 2155–2166 (2022). https://doi.org/10.1007/s00256-022-04078-6

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  • DOI: https://doi.org/10.1007/s00256-022-04078-6

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