Muscle Biopsy

What is a muscle biopsy?

A muscle biopsy is a procedure used to diagnose diseases involving muscle tissue. Tissue and cells from a specific muscle are removed and viewed microscopically. The procedure requires only a small piece of tissue to be removed from your designated muscle.

The tissue sample is obtained by inserting a biopsy needle into your muscle. If a larger sample is required, your healthcare provider may make an incision in your skin (open biopsy) and remove a larger section of muscle.

The muscle selected for your biopsy depends on the location of symptoms, which may include pain or weakness. The muscles often selected for sampling are the bicep (upper arm muscle), deltoid (shoulder muscle), or quadriceps (thigh muscle).

A related procedure that may be used to diagnose neuromuscular problems is electromyography (EMG). EMG measures the electrical activity of muscle during rest, slight contraction, and forceful contraction.

Why might I need a muscle biopsy?

A muscle biopsy is performed to assess your musculoskeletal system for abnormalities. Various disease processes can cause muscle weakness or pain. These conditions may be related to problems with your nervous system, connective tissue, vascular system, or musculoskeletal system.

A muscle biopsy helps to determine the source of the disease process, ensuring initiation of appropriate treatment.

Muscle biopsies may be performed to diagnose neuromuscular disorders, infections that affect your muscle, and other abnormalities in your muscle tissue. The following is a list of some conditions diagnosed by muscle biopsy:

  • Muscular dystrophy (MD). A broad term that describes a genetic (inherited) disorder of the muscles. Muscular dystrophy affects skeletal muscles and other organ systems. The muscles break down and are replaced with fatty deposits over time. There are many different types of muscular dystrophy.
  • Duchenne muscular dystrophy (DMD). The most common form of muscular dystrophy. DMD usually affects only males.
  • Becker muscular dystrophy. Similar to Duchenne muscular dystrophy (DMD), but usually more mild with the onset of symptoms occurring later in life.
  • Trichinosis. An infection caused by a parasite that lives in raw meat. Symptoms may include muscle pain.
  • Toxoplasmosis. An infection caused by a parasite that invades the tissue and can damage the central nervous system, especially in infants.
  • Myasthenia gravis (MG). A complex, autoimmune disorder in which antibodies destroy neuromuscular connections. This causes problems with the nerves that communicate with muscles. MG affects the voluntary muscles of the body, especially your eyes, mouth, throat, and limbs.
  • Polymyositis. A chronic disease involving skeletal muscles.
  • Dermatomyositis. A collagen disorder that causes inflammation to the skin, muscles, and subcutaneous tissue, often resulting in weakened muscles.
  • Amyotrophic lateral sclerosis (ALS). Also known as Lou Gehrig disease, ALS is a disease that attacks the nerves signaling voluntary muscle movement, eventually causing paralysis.
  • Friedreich ataxia. An inherited, genetic disorder that involves balance and coordination.

There may be other reasons for your healthcare provider to recommend a muscle biopsy.

What are the risks of a muscle biopsy?

As with any surgical procedure, complications can occur. Some possible complications may include, but are not limited to, the following:

  • Bruising and discomfort at the biopsy site
  • Prolonged bleeding from the biopsy site
  • Infection of the biopsy site

Other risks may exist, depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider prior to the procedure.

How do I get ready for a muscle biopsy?

  • Your healthcare provider will explain the procedure to you and offer the opportunity to ask any questions you may have about the procedure.
  • You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
  • In addition to a complete medical history, your healthcare provider may perform a complete physical examination to ensure you are in good health before undergoing the procedure. You may undergo blood tests or other diagnostic tests.
  • Notify your healthcare provider if you are sensitive, or allergic, to any medications, latex, tape, or anesthetic agents (local and general).
  • Notify your healthcare provider of all medications (prescribed and over-the-counter) and herbal supplements that you take.
  • Notify your provider if you have a history of bleeding disorders, or if you take any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.
  • If you are pregnant or suspect that you are pregnant, you should notify your healthcare provider.
  • You may be asked to fast for several hours prior to the procedure.
  • You may receive a sedative prior to the procedure to help you relax. Because the sedative may make you drowsy, you will need to arrange for someone to drive you home.
  • Based on your medical condition, your healthcare provider may request other specific preparation.

What happens during a muscle biopsy?

A muscle biopsy may be performed on an outpatient basis, or as part of your stay in a hospital. Procedures may vary, depending on your condition and your provider’s practices. Generally, a muscle biopsy follows this process:

  1. You will be asked to remove clothing and will be given a gown to wear.
  2. During the procedure, you will need to lie as still as possible.
  3. The skin over the biopsy site will be cleansed with an antiseptic solution.
  4. As your healthcare provider injects a local anesthetic to numb the area, you will feel a needle stick and a brief stinging sensation.
  5. Your healthcare provider will insert the biopsy needle through your numbed skin, and into the muscle where the sample is taken. You may feel some pressure, or pulling, during the procedure.
  6. If a larger sample is required, a small incision will be made into the skin’s surface. Sections of your muscle tissue may be cut using small, sharp scissors instead of a biopsy needle. You may feel mild discomfort when the muscle is cut.
  7. Your healthcare provider will withdraw the biopsy needle and will apply firm pressure to the biopsy site for a few minutes, until the bleeding has stopped.
  8. Your provider will close the opening in your skin with adhesive strips or stitches, if necessary.
  9. A sterile bandage or dressing will be applied.
  10. Your muscle tissue sample will be sent to the lab for examination.

What happens after a muscle biopsy?

Once you are home, it is important to keep the biopsy area clean and dry. Your healthcare provider will give you specific bathing instructions. If stitches are used, they will be removed during a follow-up office visit. If adhesive strips are used, they should be kept dry and generally will fall off within a few days.

The biopsy site may be tender or sore for 2 to 3 days after your muscle biopsy. Take a pain reliever for soreness, as your healthcare provider recommends. Aspirin or certain other pain medications may increase your chance for bleeding. Be sure to take only recommended medications.

Notify your healthcare provider to report any of the following:

  • Fever
  • Redness, swelling, bleeding, or other drainage from the biopsy site
  • Increased pain around the biopsy site

You may resume your usual diet and activities, unless your healthcare provider advises you otherwise. Your healthcare provider may restrict your activity for 24 hours following the procedure and ask that you avoid excessive use of the biopsied muscle.

Your provider may give you additional or alternate instructions after the procedure, depending on your particular situation.

Next steps

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • The risks and benefits of the test or procedure
  • When and where you are to have the test or procedure and who will do it
  • When and how will you get the results
  • How much will you have to pay for the test or procedure