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Neurosciences

Muscle Biopsy Procedure

Contact: (0191) 282 4443 or 282 5011 - Ward 11 staff


IntroductionShow [+]Hide [-]

A muscle biopsy is useful in the diagnosis of diseases that impair muscle function causing symptoms such as weakness, fatigue or cramps. It can also be used to test the body’s energy production (mitochondrial function).

Before your procedureShow [+]Hide [-]

No specific preparation is required beforehand.

During your procedureShow [+]Hide [-]

The procedure will take place on the Neurological Investigation Unit which is located on Ward 11 at the Royal Victoria Infirmary.

The muscle biopsy procedure takes around thirty minutes. In total about a 1cm cube sample is removed from the middle of the muscle. There are several techniques that can be used. The appropriate one depends on the specific tests required.

Open biopsy

This is performed in theatre. A 4 cm cut is made through the skin, exposing the muscle underneath and the wound is closed with stitches.

Conchotome or needle biopsy

These are performed on the ward. A specially designed instrument is passed through a 1cm cut in the skin into the muscle. To obtain a piece of muscle, the conchotome uses small jaws on the end and the needle uses a small window into which the muscle is drawn by suction and then shaved off. Adhesive strips rather than stitches close the wound.

Will it hurt?

Local anaesthetic is injected to numb the skin and the outer surface of the muscle. The muscle is not injected as this would disrupt its structure, and so mild discomfort may be felt when the muscle is cut.

Most diseases affect all muscles, even though not all may appear involved. The quadriceps muscle on the outside of the thigh is the most commonly sampled. It is a large, easily accessible muscle with no major nerves or blood vessels.

This is a simple procedure with a low risk of complications. The amount of muscle removed is very small and so this does not cause any weakness. Often a small bruise might be mildly uncomfortable for a few days. In around one in a hundred cases this might take a few weeks to settle. It is possible that permanent weakness, infection or a patch of numbness might occur but these are rare.

Check your medication!

To reduce the risk of bleeding, it is vital that you inform us of any drugs that could affect blood clotting. These include anti-flammatory tablets (such as indomethacin, ibuprofen, voltarol), anti-platelet drugs (such as aspirin, dipyridamole or clopidogrel) and anti-thrombotic drugs such as warfarin or heparin. These may need to be stopped up to two weeks prior to the biopsy. If this has not been done then the biopsy may be cancelled.

Please contact us if you are concerned regarding your medication and a risk of bleeding or indeed any other aspect of the procedure at either 0191 282 4443 or 0191 282 5011 from 8.00am until 6.00pm, Monday to Friday.

After your procedureShow [+]Hide [-]

When can I go home?

It is recommended that patients remain in the ward for a further two hours after a biopsy. This is to deal with any recurrence of bleeding that might occur with muscle activity. The biopsy site will be regularly checked over this two hour period. A pressure bandage will be applied to reduce bleeding from the skin. Signs of a recurrence a bleeding within the muscle include sudden increased pain, swelling, or blood staining extending to the edges of the dressing. If this occurs between checks then alert nursing or medical staff immediately. The treatment of any recurrence of bleeding is to apply continuous pressure to the biopsy site for ten minutes.

What about the stitches?

The skin wound is closed using either dissolvable stitches or steristrips (sticky tape) and covered with a clear shower-proof dressing. The dressing is to reduce the risk of infection and to prevent the steristrips from getting wet as they will lose their stickiness. The dressing is water resistant rather than waterproof and so showers rather than baths are recommended until five days after the biopsy when it should be removed by soaking it in water. Occasionally, it is necessary to close the skin with non-dissolvable stitches (the doctor or nurse will let you know). In this case you should make an appointment for seven days after your biopsy with the practice nurse at your GP surgery who will remove these for you.

Do I need to rest?

It is advisable to avoid strenuous activity for the first 5 days after your biopsy as this might delay the healing process and potentially result in bleeding. It should not limit routine household tasks or an office based job but might interfere with the ability to perform a physically demanding job. Only exercise of mild intensity involving the biopsied muscle should be undertaken for two weeks.

Pain relief

If the biopsy site is uncomfortable pain relief should be paracetamol or codeine. Anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen should be avoided for 48 hours.

When will I get the results?

This depends on the particular tests requested by your doctor but it is usually four to six weeks until a report reaches your referring consultant. A copy of the result will also be sent to your GP.

Any Concerns

If you have any problems once you are discharged you can contact either your own GP or, if you prefer, Sister Angela Phillips or any of the staff on Ward 11 at either 0191 282 4443 or 0191 282 5011 from 8.00am until 6.00pm, Monday to Friday.

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