Dr. Arthur Lee Osterman JR., MD

Although biopsy is most often associated with cancer, it can also be used to check for other diseases, such as infections. A biopsy sample can be scraped, cut, collected with a needle, taken with a machine that punches out a tiny piece, or removed with the tiny tools in an endoscope.

In most cases, a biopsy is a simple outpatient procedure. Depending on the procedure, patients may need to stop taking certain medications beforehand, such as blood thinners. It is important for patients to tell doctors if they are pregnant, as certain biopsies require the use of x-rays to guide the needle to the right location. There is usually very little pain associated with a biopsy. Patients will have to wait a few days to hear the results.

Both injection and aspiration are techniques that involve inserting a needle connected to a syringe directly into the joint. Aspiration involves the removal of excess fluid, and injection is the placement of medication directly into the joint space via the needle. Both procedures may be performed at the same time. In both cases a local anesthetic may be used, the skin will be cleaned and disinfected, and then the needle will be inserted. In some cases, especially if the injection or aspiration is in a large and deep joint such as the hip or spine, ultrasound may be used to guide the needle to the exact location desired.

In some cases, irritation to the joint can cause fluid to build up so significantly that the joint hurts and can no longer move well. Aspiration removes some of the excess fluid and relieves the pressure. In addition, aspiration can be used to provide a sample of joint fluid if it needs to be examined microscopically for the presence of white blood cells, bacteria, or crystal formations.

Certain injuries and diseases that affect joints are inflammatory in nature, such as rheumatoid arthritis, tendonitis or gout. These diseases may be helped by the local injection of anti-inflammatory medications directly into the affected joint. In this case, corticosteroids such as methylprednisone are usually used. Relief from the pain may be felt right away and may last for weeks or even months.

In some cases, such as with osteoarthritis, the cartilage buffer between the two bones wears down and pain comes from bones rubbing against each other. In this case, injection of a lubricating agent such as hyaluronic acid may be beneficial. It provides a slippery cushion between the bones to relieve pain that can last for months.

Tendon transfer surgery can be performed on the arms, hands, feet, or other areas of the body where a muscle becomes unable to pull on its tendon. A nearby tendon is detached from its bone, but kept connected to its muscle, nerves, and blood supply. The loose end is connected to the bone that the patient could not move. After the attachment heals, the patient will be able to move that part of the body by flexing the newly connected muscle.

One of the benefits to tendon transfer surgery is that it does not have to be performed right away after an injury. It can be successful even if the affected area has been paralyzed for years. It does take time to retrain the brain to use a different muscle for movement, but the surgery is a powerful option to restore needed motion.