 Following a discussion of the procedure with the patient and his mother, including its risks, benefits, alternatives and steps to prevent infection, informed written consent was obtained and documented in the patient's chart. The time-out form was completed to confirm patient identity and side/type of procedure. All operators present for the case performed standard preprocedural prep including hand washing, sterile gloves, mask and cap. The patient was prepped and draped in the usual aseptic fashion. Local anesthesia over the target area was obtained by 1% lidocaine. Midazolam and fentanyl were administered IV by the nurses during continuous hemodynamic monitoring. A localizing CT examination demonstrated an expansile lesion within the medial aspect of the right acetabulum corresponding to the findings seen on recent MRI. Using CT guidance, an 18-gauge Achieve core biopsy needle was advanced into the lesion. 4 18-gauge core biopsy specimens were obtained. The core biopsy specimens were placed in formalin. The core biopsy specimens were hand carried to the Surgical Pathology lab. A 20-gauge Chiba needle was advanced into the lesion and approximately 15 cc's of bloody fluid was aspirated from the lesion. The aspirate was handed directly to cytopathology.The patient tolerated the procedure well without immediate complication. Routine post procedure instructions were communicated to the patient.ESTIMATED BLOOD LOSS: Less than 5cc's. Dermabond as well as a Tegaderm bandage were placed on the patient’s skin.
CT guided core needle biopsy of right acetabular lesion.