Suspected intra-articular soft-tissue tumours and tumour-like lesions: Performance of image-guided core needle biopsy

To determine the efficacy of image-guided core needle biopsy (IGCNB) in patients presenting with suspected intra-articular soft tissue tumours or tumour-like lesions.

Retrospective study of patients referred to a musculoskeletal oncology service between January 2019 and May 2020 with a suspected intra-articular soft tissue tumour over a 16-month period. Data collected included patient age, gender, joint involved and maximal lesion size. Type of image-guidance (ultrasound or computed tomography), type of needle and type of anaesthesia, general anaesthetic (GA) or local anaesthetic (LA), were recorded, as was the histological diagnosis. For patients who proceeded to surgical excision, the IGCNB histology result was correlated with resection histology. Descriptive statistics were used and complications were also noted.

By the termination of data collection 91 patients underwent IGCNB, 32 (35.2 %) males and 59 (64.8 %) females with a mean age of 41.4 years (age range 3-86 years). The joints involved were the knee (n = 73; 80.2 %), ankle (n = 12; 13.2 %), hip (n = 3; 3.3 %), shoulder (n = 1; 1.1 %), elbow (n = 1; 1.1 %) and wrist (n = 1; 1.1 %). Biopsy types were as follows: US-guided GA (n = 29; 31.9 %), US-guided LA (n = 37; 40.7 %), CT-guided GA, (n = 23; 25.3 %), CT-guided LA (n = 2; 2.2 %). Mean maximal tumour dimension for 76 focal lesions was 36.5 mm (range 18-113 mm). IGCNB yielded a definitive histological result in 85 of 91 cases (93.4 %), 44 of whom went on to surgical resection. Concordance between IGCNB and resection histology was achieved in 42 of 44 cases (95.5 %). The commonest diagnosis was tenosynovial giant cell tumour, with only a single malignant lesion identified. There were no recorded immediate or delayed complications.

IGCNB of suspected intra-articular tumours or tumour-like lesions is a highly effective and safe technique.