Bone marrow sampling - Investigations and procedures

Bone marrow sampling

Bone marrow sampling is often essential in diagnosing haematological conditions. There are two sampling techniques available:

·        Bone marrow aspiration: Sampling normally occurs from the iliac crest. Following skin preparation local anaesthetic is infiltrated into the skin and down to the periosteum. The aspiration needle is inserted through the skin and advanced rotating clockwise and counterclockwise until the marrow cavity is entered. The stylet is then removed and 2–3 mL of marrow is aspirated using a syringe. The sample is spread onto glass slides and stained as required.

·        Bone marrow trephine: Following skin preparation, anaesthetic and incision the biopsy needle (e.g. Jamshidi needle) is inserted and advanced until it makes contact with the bone. The stylet is then removed and the needle advanced using alternating clockwise-counterclockwise motion into the bone marrow cavity. The sample is removed from the needle, fixed, decalcified and stained as required.