What did the paper mention is important to identify on imaging before biopsy to minimize risk of accidentally causing a pathologic fracture during the procedure?

• A. Reduced cortical thickness
• B. Increased bone density
• C. Presence of a soft tissue mass
• D. Normal cortex

Answer: (A)

Assessing bone integrity on imaging before performing a percutaneous biopsy is essential to minimize iatrogenic fracture. If the cortex is reduced or thinning, the bone’s mechanical strength is compromised, so inserting a biopsy needle or manipulating the instrument can readily propagate a fracture. Detecting reduced cortical thickness signals that this site may be too fragile for biopsy and prompts choosing a route or location with preserved cortex, adjusting technique, or opting for an alternative approach with stabilization if biopsy is necessary. In contrast, increased bone density doesn’t inherently indicate fracture risk from biopsy, a soft tissue mass describes lesion extent rather than cortical strength, and a normal cortex implies the risk is lower than with thinning cortex.