{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:17:11Z","timestamp":1777929431904,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III \u2013 Retrospective Cohort Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Musculoskeletal lesions commonly present as pain, masses, or incidental imaging findings. Accurate diagnosis is critical for treatment planning. Although open biopsy was historically considered the gold standard, core needle biopsy (CNB) has emerged as a minimally invasive and reliable diagnostic method with a favorable safety profile. The primary objective was to determine the diagnostic accuracy of image-guided core needle biopsy (CNB) for musculoskeletal lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of 426 patients who underwent image-guided CNB for musculoskeletal lesions at a single tertiary referral center between January 2014 and December 2020. Patient demographics, biopsy characteristics, and diagnostic outcomes were analyzed. Diagnostic performance was evaluated using sensitivity, specificity, predictive values, and area under the ROC curve (AUC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most patients were adults (82.4%) and male (56.6%). The lower limb was the most common biopsy region (43.2%), with the trunk (26.3%), upper limb (15.5%), and pelvis (14.3%) following in order of frequency. CNB demonstrated a sensitivity of 98.8%, specificity of 72.3%, negative predictive value of 99.0%, and overall accuracy of 82.3% (AUC = 0.855).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Image-guided CNB provides high diagnostic sensitivity and excellent negative predictive value for musculoskeletal lesions, with a very low complication rate. While it is effective as a first-line diagnostic tool, limitations remain in specificity and tumor subtype confirmation, particularly in heterogeneous or necrotic lesions. Standardized protocols and multidisciplinary interpretation are essential to optimize accuracy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10225536251411641","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T06:44:15Z","timestamp":1766731455000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic accuracy and safety of core needle biopsy for musculoskeletal lesions: A retrospective cohort study from a tertiary referral center"],"prefix":"10.1177","volume":"33","author":[{"given":"Wazzan","family":"Aljuhani","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia"},{"name":"King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bandar","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Orthopedics, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia"},{"name":"Department of Orthopedics, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bayan","family":"Altorbak","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Turki","family":"Althunayan","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia"},{"name":"King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8688-7501","authenticated-orcid":false,"given":"Tariq","family":"Almunyif","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, King Salman Hospital, Riyadh First Health Cluster, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia"},{"name":"King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,25]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198011000-00013"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2020.12.012"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/230949901302100123"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199605000-00002"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20504"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199605000-00004"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198264080-00002"},{"issue":"2","key":"e_1_3_7_9_2","first-page":"176","article-title":"Appropriate techniques for musculoskeletal tumor biopsy","volume":"23","author":"Markel DC","year":"1994","unstructured":"Markel DC, Neumann KU, Steinau HU. Appropriate techniques for musculoskeletal tumor biopsy. Orthop Rev 1994; 23(2): 176\u2013180.","journal-title":"Orthop Rev"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol31020067"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2483071742"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-007-0421-5"},{"issue":"5","key":"e_1_3_7_13_2","first-page":"e60757","article-title":"An image-guided percutaneous core needle biopsy for accurate assessment of musculoskeletal tumors: a targeted diagnosis","volume":"16","author":"Arvind Kumar B","year":"2024","unstructured":"Arvind Kumar B, Peddamadyam S, Krishna V, et al. An image-guided percutaneous core needle biopsy for accurate assessment of musculoskeletal tumors: a targeted diagnosis. Cureus 2024; 16(5): e60757.","journal-title":"Cureus"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.22.01259"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1735471"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ro.2017.04.005"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.15557\/JoU.2021.0004"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-010-1970-6"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02305557"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21154"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-008-0678-x"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-010-1847-y"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000229302.52147.c7"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2011.03.019"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2022.12.467"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-5090-y"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39339.610000.BE"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_7_29_2","volume-title":"IBM SPSS statistics for windows, version 25.0","author":"IBM Corp","year":"2017","unstructured":"IBM Corp. IBM SPSS statistics for windows, version 25.0. IBM Corp; 2017."},{"key":"e_1_3_7_30_2","volume-title":"ROC curve analysis with MedCalc","author":"Schoonjans F","year":"2018","unstructured":"Schoonjans F. ROC curve analysis with MedCalc. MedCalc, 2018."},{"key":"e_1_3_7_31_2","first-page":"100023","article-title":"Analysis on diagnostic failure of US-guided core needle biopsy for soft tissue tumors","volume":"5","author":"Zhang YL","year":"2023","unstructured":"Zhang YL, Ma Q, Hu Y, et al. Analysis on diagnostic failure of US-guided core needle biopsy for soft tissue tumors. Res Diagn Interv Imaging 2023; 5: 100023.","journal-title":"Res Diagn Interv Imaging"},{"key":"e_1_3_7_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-010-1422-5"},{"issue":"1","key":"e_1_3_7_33_2","first-page":"893","article-title":"Open vs percutaneous core needle biopsy for musculoskeletal malignancies","volume":"31","author":"Qaisar A","year":"2024","unstructured":"Qaisar A, Ullah N, Salman M, et al. Open vs percutaneous core needle biopsy for musculoskeletal malignancies. J Popul Ther Clin Pharmacol 2024; 31(1): 893\u2013901.","journal-title":"J Popul Ther Clin Pharmacol"},{"key":"e_1_3_7_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-017-2579-8"},{"key":"e_1_3_7_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-002-0474-3"},{"key":"e_1_3_7_36_2","doi-asserted-by":"publisher","DOI":"10.1159\/000324997"}],"container-title":["Journal of Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10225536251411641","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10225536251411641","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10225536251411641","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:33:01Z","timestamp":1777678381000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10225536251411641"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":35,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1177\/10225536251411641"],"URL":"https:\/\/doi.org\/10.1177\/10225536251411641","relation":{},"ISSN":["1022-5536","2309-4990"],"issn-type":[{"value":"1022-5536","type":"print"},{"value":"2309-4990","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"article-number":"10225536251411641"}}