The role of radiology in orthopaedic sepsis

The concept of needle biopsy of bone--a technique that is performed frequently at the University of California, San Diego--must be considered. Either fluoroscopy or computed tomography can be used to guide the biopsy. The percutaneous approach can eliminate the need for surgery in certain cases in which the orthopaedist would otherwise need to perform an open procedure. A large-bore Craig needle is generally employed, and diagnostic tissue can be obtained, even from difficult sites in most cases. The use of CT in this situation can be helpful, since it documents the exact location of the needle with respect to the affected area (Fig 30).