Outcomes of Image guided bone biopsy for osteomyelitis.

Purpose: To investigate the utility of CT-guided percutaneous bone biopsy in diagnosing osteomyelitis in patients with varying clinical presentations.

Methods/Materials: This is a retrospective analysis of CT-guided bone biopsies performed over a 5-year period. Evaluated is the correlation between clinical factors (fever, leukocytosis, and positive blood culture) and the diagnosis of osteomyelitis using a combined scoring system (0-3 points). Observational analysis, Pearson correlation coefficients, and chi-square tests for independence were employed.

Results: A statistically significant association was observed between leukocytosis (p = 0.023) and positive blood culture (p = 0.006) with osteomyelitis. Patients with a total score of 0 exhibited a 22.2% positive biopsy rate, while those with a score of 2-3 had a significantly higher positive rate of 77.8%, compared to patients scoring 0-1 (26.3%). A moderate positive correlation was identified between higher scores and osteomyelitis diagnosis (r = 0.405, N = 47, p = 0.005).

Conclusions: CT-guided bone biopsy cannot be excluded as a diagnostic tool, even in patients lacking overt clinical symptoms. Patients suspected of osteomyelitis, particularly those with multiple positive clinical indicators, stand to benefit the most from this procedure. This study underscores the significance of considering clinical findings when determining the suitability of CT-guided percutaneous bone biopsy. Leukocytosis and positive blood culture serve as reliable predictors of a positive bone biopsy, emphasizing the importance of informed clinical decision-making in these cases.