![]() On day 6, ultrasonography confirmed pulsatile flow of the heterogeneous mass in the right vastus lateralis (Figure (Figure1b). Color in (b) reflects arterial flow in the heterogeneous mass. Transverse ultrasound images of right vastus lateralis showing the intramuscular hematoma five (a), six (b), eight (c), nine (d), twelve (e), and nineteen (f) days after percutaneous microbiopsy. Severity of pain remained moderate throughout day 4, and in the evening tightness of the leg had increased. On day 4 the participant assisted with moving furniture for ~4‐h. The participant maintained an antalgic gait pattern and reported moderate shooting pain throughout the entire length of his right leg upon transition from sitting to standing. Pain in the participant's right leg was reduced to moderate. ![]() Before bed, the participant took 800 mg ibuprofen-severe sharp pain persisted making sleep difficult.ĭay 2– 4. The participant contacted the primary investigator and was prescribed rest, ice, compression, and elevation. Visual inspection of the limb revealed slight bleeding, swelling, and warmth in the area surrounding the biopsy site. At 20:00 of the same evening, after having been seated for approximately 2 h, the participant stood up and experienced immediate severe sharp, shooting, and throbbing pain. The following day leg pain did not improve and the participant demonstrated an antalgic gait pattern. In the afternoon, the participant experienced pain while flexing his leg and had difficulty jumping while playing volleyball.ĭay 1. Immediately post‐biopsy, the participant experienced stiffness and favored his right leg. The muscle biopsy was performed on the participants right leg at 08:30 on Day 0. Therefore, the present case report follows a young male's recovery from a percutaneous muscle biopsy‐induced hemorrhage/hematoma of the right vastus lateralis with the specific aims of (1) informing future participants, researchers, and clinicians on expected time course of recovery and (2) informing methods to minimize future participant adverse event risk during and after the microbiopsy procedure.ĭay 0. Further, due to the infrequency of complications associated with Bergstrom needle muscle biopsies (Tarnopolsky et al., 2011) there is a deficiency of information regarding the development and progression of complications as well as the lived experiences of affected individuals. Unlike the Bergstrom muscle biopsy procedure, potential complications associated with microbiopsies of human skeletal muscle have not been documented. Although the microbiopsy technique results in the extraction of a smaller piece of muscle tissue than the Bergstrom needle, it does not require a pre‐biopsy incision of the skin, involves a lower gauge needle and is perceived as being less invasive and painful than the Bergstrom technique (Bonafiglia et al., 2020 Hughes et al., 2015). Recently, percutaneous microbiopsy needles have been used as an alternative to the Bergstrom needle for obtaining human skeletal muscle biopsy (Hughes et al., 2015). The procedure is typically performed using the Bergstrom needle biopsy technique (Ekblom, 2017 Shanely et al., 2014), which is relatively less invasive compared to the open biopsy method and has a minimal complication rate (see Tarnopolsky et al. Skeletal muscle biopsies are commonly completed to assess changes in protein content (Egan et al., 2013 Little et al., 2010), gene expression (Islam et al., 2019 Mahoney et al., 2005), and enzymatic activities (Carter et al., 2001 MacDougall et al., 1998) in response to exercise. ![]() When there is indication of hematoma development, compression should be applied, and the participant should avoid exercise and physical activity. To minimize the risk of muscle biopsy‐induced hemorrhage/hematoma, we advise post‐biopsy compression for up to 15 min and post‐biopsy follow‐up should be completed for up to 72 h. The present case report demonstrates that the inadvertent hemorrhaging of a neighboring vessel by percutaneous microbiopsy procedure can be debilitating. Therefore, the present case report follows a young male's recovery from a muscle biopsy‐induced hemorrhage/hematoma of the right vastus lateralis with the specific aims of (1) informing future participants, researchers, and clinicians on expected time course of recovery and (2) informing methods to minimize future participant adverse event risk during and after the percutaneous microbiopsy procedure. Recently, percutaneous microbiopsy needles have been used as a less invasive alternative to the Bergstrom needle for obtaining human skeletal muscle biopsy to assess changes in protein content, gene expression, and enzymatic activities.
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