Skip to main content

Advertisement

SpringerLink
Log in

A measuring technique for intra-osseous pressure

  • Technical Report
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

Pulsatile intra-osseous pressures result in bone remodeling, and therefore may affect lesion growth and response to treatment. However, there is no known method used to measure intra-osseous pressures. The purpose of this study is to describe a novel image-guided technique for measuring intra-osseous pressures.

Materials and methods

This study was IRB-approved and HIPAA compliant. Written informed consent was obtained. Intra-osseous pressure measurements were performed during a CT-guided bone marrow biopsy in eight patients (6 male, 2 female) with mean age 66 ± 13 years (median 72, range 45–87) and suspected or known bone marrow disease. Bone marrow pressure measurements were obtained connecting the biopsy needle to a dedicated monitor using a standard arterial line setup. Monitor data was collected at 5-s intervals in order to record continuous pressure measurements for 2 min.

Results

Pressure measurements were successfully performed in all 8 patients. The mean bone marrow pressures were 36.8 ± 7.2 mmHg (median 37.7, range 24.7–47.4). The peak and trough pressures varied by 11%, and the standard deviation of mean pressure measurement varied by 18%. Our findings for marrow pressure measures most closely approximate the pressure profile of the venous system.

Conclusion

We describe a novel and minimally invasive technique able to provide functional data of bone marrow. This technique has the potential to provide insights into normal and diseased bone marrow and may be helpful to evaluate features of cystic and vascular tumors that may be amenable to percutaneous treatments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Hillsley MV, Frangos JA. Alkaline phosphatase in osteoblasts is down-regulated by pulsatile fluid flow. Calcif Tissue Int. 1997;60(1):48–53.

    Article  CAS  Google Scholar 

  2. Nauman EA, Satcher RL, Keaveny TM, Halloran BP, Bikle DD. Osteoblasts respond to pulsatile fluid flow with short-term increases in PGE(2) but no change in mineralization. J Appl Physiol Bethesda Md 1985. 2001;90(5):1849–54.

    CAS  Google Scholar 

  3. Johnson MW. Behavior of fluid in stressed bone and cellular stimulation. Calcif Tissue Int. 1984;36(Suppl 1):S72–6.

    Article  Google Scholar 

  4. Jendrucko RJ, Hyman WA, Newell PH, Chakraborty BK. Theoretical evidence for the generation of high pressure in bone cells. J Biomech. 1976;9(2):87–91.

    Article  CAS  Google Scholar 

  5. Rodan GA, Bourret LA, Harvey A, Mensi T. Cyclic AMP and cyclic GMP: mediators of the mechanical effects on bone remodeling. Science. 1975;189(4201):467–9.

    Article  CAS  Google Scholar 

  6. Price C, Zhou X, Li W, Wang L. Real-time measurement of solute transport within the lacunar-canalicular system of mechanically loaded bone: direct evidence for load-induced fluid flow. J Bone Miner Res Off J Am Soc Bone Miner Res. 2011;26(2):277–85.

    Article  CAS  Google Scholar 

  7. Piekarski K, Munro M. Transport mechanism operating between blood supply and osteocytes in long bones. Nature. 1977;269(5623):80–2.

    Article  CAS  Google Scholar 

  8. Gross D, Williams WS. Streaming potential and the electromechanical response of physiologically-moist bone. J Biomech. 1982;15(4):277–95.

    Article  CAS  Google Scholar 

  9. Starkebaum W, Pollack SR, Korostoff E. Microelectrode studies of stress-generated potentials in four-point bending of bone. J Biomed Mater Res. 1979;13(5):729–51.

    Article  CAS  Google Scholar 

  10. Bourne G ed. Bassett CAL, Biophysical principles affecting bone structure. In: The biochemistry and physiology of bone. New York: Academic Press; 1971.

  11. Kónya A, Szendröi M. Aneurysmal bone cysts treated by superselective embolization. Skelet Radiol. 1992;21(3):167–72.

    Article  Google Scholar 

  12. Rossi G, Angelini A, Mavrogenis AF, Rimondi E, Ruggieri P. Successful treatment of aneurysmal bone cyst of the hip in a child by selective transcatheter arterial embolization. J Vasc Interv Radiol JVIR. 2010;21(10):1591–5.

    Article  Google Scholar 

  13. Chang CY, Kattapuram SV, Huang AJ, Simeone FJ, Torriani M, Bredella MA. Treatment of aneurysmal bone cysts by percutaneous CT-guided injection of calcitonin and steroid. Skelet Radiol. 2017;46(1):35–40.

    Article  Google Scholar 

  14. Shiels WE, Mayerson JL. Percutaneous doxycycline treatment of aneurysmal bone cysts with low recurrence rate: a preliminary report. Clin Orthop. 2013;471(8):2675–83.

    Article  Google Scholar 

  15. Lambot-Juhan K, Pannier S, Grévent D, et al. Primary aneurysmal bone cysts in children: percutaneous sclerotherapy with absolute alcohol and proposal of a vascular classification. Pediatr Radiol. 2012;42(5):599–605.

    Article  CAS  Google Scholar 

  16. Mohit AA, Eskridge J, Ellenbogen R, Shaffrey CI. Aneurysmal bone cyst of the atlas: successful treatment through selective arterial embolization: case report. Neurosurgery. 2004;55(4):982.

    Article  Google Scholar 

  17. Adams HJA, Kwee TC, de Keizer B, et al. Systematic review and meta-analysis on the diagnostic performance of FDG-PET/CT in detecting bone marrow involvement in newly diagnosed Hodgkin lymphoma: is bone marrow biopsy still necessary? Ann Oncol Off J Eur Soc Med Oncol. 2014;25(5):921–7.

    Article  CAS  Google Scholar 

  18. Zapata CP, Cuglievan B, Zapata CM, et al. PET/CT versus bone marrow biopsy in the initial evaluation of bone marrow infiltration in various pediatric malignancies. Pediatr Blood Cancer. 2018;65(2).

  19. Liebross RH, Ha CS, Cox JD, Weber D, Delasalle K, Alexanian R. Clinical course of solitary extramedullary plasmacytoma. Radiother Oncol J Eur Soc Ther Radiol Oncol. 1999;52(3):245–9.

    Article  CAS  Google Scholar 

  20. Dimopoulos MA, Moulopoulos LA, Maniatis A, Alexanian R. Solitary plasmacytoma of bone and asymptomatic multiple myeloma. Blood. 2000;96(6):2037–44.

    Article  CAS  Google Scholar 

Download references

Funding

This project was supported by the Massachusetts General Hospital Schlaeger Fellowship Award.

Author information

Authors and Affiliations

  1. Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA

    Connie Y. Chang, Kaitlyn J. Yeh & Martin Torriani

  2. Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA

    Lauren A. Roller

Authors
  1. Connie Y. Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kaitlyn J. Yeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lauren A. Roller
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Martin Torriani
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Connie Y. Chang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human subjects were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The study was approved by the local Institutional Review Board (IRB) and HIPAA compliant. Written informed consent was obtained from all patients.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chang, C.Y., Yeh, K.J., Roller, L.A. et al. A measuring technique for intra-osseous pressure. Skeletal Radiol 50, 1461–1464 (2021). https://doi.org/10.1007/s00256-020-03671-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-020-03671-x

Keywords

Search

Navigation