STUDY OF OSTEOMYELITIS - UTILITY OF COMBINED HISTOLOGIC AND MICROBIOLOGIC EVALUATION OF PERCUTANEOUS BIOPSY SAMPLES

PURPOSE: To determine the utility of combined histologic and microbiol ogic evaluation of percutaneous biopsy samples in cases of suspected o steomyelitis. MATERIALS AND METHODS: Twenty-five patients with suspect ed osteomyelitis were prospectively studied over a 1-year period. With usual trephine techniques under radiologic guidance, core and aspirat ion biopsy samples were obtained in each patient for both histologic a nd microbiologic analyses. RESULTS: Sixteen biopsy specimens demonstra ted histologic evidence of osteomyelitis. Of these, eight were also cu lture positive. Seven of the eight culture-negative, histologically po sitive cases were interpreted as chronic osteomyelitis. In no patient were cultures positive and histologic findings negative. Three of 19 p atients with proved osteomyelitis had negative histologic and microbio logic findings. The sensitivity of culture in the diagnosis of osteomy elitis in our study was 42%; the sensitivity of both culture and histo logic findings was 84%. CONCLUSION: Although the volume of a biopsy sp ecimen is a major determinant of culture yield, a portion of a percuta neous biopsy sample should be histologically evaluated for possible os teomyelitis.