Iliac Crest Bone Marrow Aspiration: Fluoroscopic Guidance




Keywords

aspiration, biopsy, BMAC, bone marrow aspirate, flouroscopy, iliac crest, regenerative, stem cells

 



Note: Please see pages ii , iii for a list of anatomic terms/abbreviations used throughout this book.


A parallel technique between the table of the ilium under fluoroscopic guidance avoids breach and allows for aspiration from multiple sites to maximize yield.




Trajectory View ( Fig. 36A.1 )





  • The entry point for the bone marrow aspirate trocar is not more than 10 cm cephalad to the posterior superior iliac spine .




    Fig. 36A.1


    A, Fluoroscopic image of iliac crest biopsy, trajectory view. B, Radiopaque structures, trajectory view. C, Radiolucent structures, trajectory view.



  • The image intensifier is obliqued approximately 40 degrees contralaterally.



  • The C-arm is then tilted cranially approximately 35 degrees.



  • The ideal “setup view” delineates the medial and lateral tables of the posterior iliac crest.



  • In the trajectory view, the needle should be placed parallel to the fluoroscopic beam.



  • Once the trocar penetrates the cortical bone, the sharp tip of the stylet can be exchanged with a blunt tip.



  • Other multiplanar imaging views should also be utilized for needle advancement.



  • The needle is advanced 4 to 8 cm between the medial and lateral tables of the ilium.


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Jan 27, 2019 | Posted by in RHEUMATOLOGY | Comments Off on Iliac Crest Bone Marrow Aspiration: Fluoroscopic Guidance
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