title: Evaluation of the use of fluoroscopy guided needle biopsies for diagnosing cases of suspected pathological fractures.
abstract: OBJECTIVE
  Establishing an early and accurate diagnosis in cases of suspected pathological fractures is crucial to initiate optimal treatment without delay. The use of percutaneous biopsy has become popular over the past few years. However, there is a paucity of information regarding the efficacy and safety of percutaneous biopsy procedures guided by fluoroscopy.
  
  
  METHODS
  A total of 137 percutaneous C-arm fluoroscopy-guided core needle biopsy (CNB) procedures were performed in 135 patients with suspected pathological fractures. The sensitivity, specificity, accuracy, and overall prognostic value of these procedures were evaluated. Complications, if any, were documented for all cases.
  
  
  RESULTS
  The overall sensitivity, specificity, and accuracy were 82.0%, 100%, and 83.2%, respectively. The positive and negative predictive value was 100% and 28.1%, respectively. There were 23 "false negative" cases in our study, of which 15 were benign lesions and eight were malignant tumors. No "false-positives" were found. Major procedure-related complications occurred in three patients (2.2%). These complications, however, did not alter the prognosis of these patients.
  
  
  CONCLUSIONS
  Percutaneous C-arm fluoroscopy-guided biopsy procedures are both effective and safe for diagnosis of suspected pathological fractures in the appendicular skeleton.
authors.affiliation: Department of Musculoskeletal Tumor, Third Hospital of Hebei Medical University, Hebei, China.
authors.forename: Dianwen
authors.initials: D
authors.lastname: Qi
authors.affiliation: Department of Musculoskeletal Tumor, Third Hospital of Hebei Medical University, Hebei, China.
authors.forename: Tongyu
authors.initials: T
authors.lastname: Hu
authors.affiliation: Department of Musculoskeletal Tumor, Third Hospital of Hebei Medical University, Hebei, China.
authors.forename: Guochuan
authors.initials: G
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D001859:Bone Neoplasms / Q000150:complications*; D002648:Child; D005260:Female; D005471:Fluoroscopy; D050723:Fractures, Bone / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: C-arm fluoroscopy; appendicular skeleton; core needle biopsy; diagnosis pathological fracture