title: Clinic-based biopsy with a small curette: is it a reliable and safe option in extremity tumours?
abstract: OBJECTIVE
  To establish the diagnostic accuracy and safety of clinic-based biopsy done with a small curette.
  
  
  METHODS
  The retrospective study was conducted at Aga Khan University Hospital Karachi and comprised data of patients who underwent biopsy procedure of extremity tumours in clinic under local anaesthesia from July 2009 to June 2012. Patients who underwent the procedure in operating room under general anaesthesia were excluded and so were those with insufficient or missing information, or those who had the final procedure done elsewhere. Clinical parameters were evaluated and histo-pathology was compared with the final resected specimen.
  
  
  RESULTS
  The mean age of the 51 patients in the study was 32±19.6 years. Lower extremity was involved in 37(73%) cases, and the most common tumour was osteosarcoma in 9(17%).Biopsy was inconclusive in 2(4%) patients, leaving the clinical accuracy to be 94%. The cost of clinic-based biopsy was at least seven times less than those done in the operating room under general anaesthesia.
  
  
  CONCLUSIONS
  Biopsy done in a clinic with a small curette is accurate, safe and cost-effective method.
authors.affiliation: Department of Surgery, Aga Khan University Hospital, Karachi.
authors.forename: Waseem
authors.initials: W
authors.lastname: Ahmed
authors.affiliation: Department of Surgery, Aga Khan University Hospital, Karachi.
authors.forename: Masood
authors.initials: M
authors.lastname: Umer
authors.affiliation: Department of Orthopedic Surgery, Allied Hospital, Punjab Medical College, Faisalabad.
authors.forename: Yasir
authors.initials: Y
authors.lastname: Mohib
authors.affiliation: Department of Surgery, Aga Khan University Hospital, Karachi.
authors.forename: Rizwan Haroon
authors.initials: RH
authors.lastname: Rashid
keywords: Biopsy, Histopathology, Clinic biopsy, Curette.