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Hello, any advice on what code to use for this procedure for the cement injection femoral neck? Thank you!
1. CT-guided biopsy of the femoral neck.
2. Internal fixation of the femoral neck with bone cement.
HISTORY: The patient with a 7-month history of right hip
pain, which likely started as a stress fracture. However, he has not been
healing despite multiple attempts to rest and nonweightbearing.
DESCRIPTION OF PROCEDURE:
The right hip was prepped and draped in standard, sterile fashion.
Local anesthesia was performed with 2% lidocaine and bupivacaine.
Preliminary CT was performed. Under CT guidance, a 9-gauge bone biopsy needle
was then introduced laterally into the femoral neck. The CT with multiple
reconstructions performed in the room confirmed position of the needle in the
right femoral neck.
Single biopsy was then performed. Subsequently, approximately 6 mL of bone
cement with hydroxyapatite were then injected in the femoral neck. We were
careful to avoid placing the cement too close to the cartilage. The cement was
injected under CT
guidance with multiple intermittent fluoroscopies. Postprocedure CT was then
performed demonstrating a good amount of cement in good position in the right
femoral neck. The patient tolerated the procedure well, and there were no
immediate
complications.
INTERPRETATION: Preliminary CT demonstrated a small amount of periosteal
reaction in the lower portion of the femoral neck consistent with stress
fracture. No linear fracture was noted. CT confirmed position of the needle in
the femoral neck. CT was
injected during cement administration. Post procedure CT demonstrated a good
amount of cement in the femoral neck without extravasation of cement.
IMPRESSION:
1. Successful CT-guided biopsy of the abnormal area seen on the MRI in the
femoral neck.
2. Successful internal fixation femoral neck with bone cement.
1. CT-guided biopsy of the femoral neck.
2. Internal fixation of the femoral neck with bone cement.
HISTORY: The patient with a 7-month history of right hip
pain, which likely started as a stress fracture. However, he has not been
healing despite multiple attempts to rest and nonweightbearing.
DESCRIPTION OF PROCEDURE:
The right hip was prepped and draped in standard, sterile fashion.
Local anesthesia was performed with 2% lidocaine and bupivacaine.
Preliminary CT was performed. Under CT guidance, a 9-gauge bone biopsy needle
was then introduced laterally into the femoral neck. The CT with multiple
reconstructions performed in the room confirmed position of the needle in the
right femoral neck.
Single biopsy was then performed. Subsequently, approximately 6 mL of bone
cement with hydroxyapatite were then injected in the femoral neck. We were
careful to avoid placing the cement too close to the cartilage. The cement was
injected under CT
guidance with multiple intermittent fluoroscopies. Postprocedure CT was then
performed demonstrating a good amount of cement in good position in the right
femoral neck. The patient tolerated the procedure well, and there were no
immediate
complications.
INTERPRETATION: Preliminary CT demonstrated a small amount of periosteal
reaction in the lower portion of the femoral neck consistent with stress
fracture. No linear fracture was noted. CT confirmed position of the needle in
the femoral neck. CT was
injected during cement administration. Post procedure CT demonstrated a good
amount of cement in the femoral neck without extravasation of cement.
IMPRESSION:
1. Successful CT-guided biopsy of the abnormal area seen on the MRI in the
femoral neck.
2. Successful internal fixation femoral neck with bone cement.