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Optimising muscle biopsy: ultrasound-guided technique for enhanced accuracy and safety
R. Campanilho-Marques1, F. Costa2, E. Dourado3, M. Bandeira4, R. Roque5, P. Coelho6, J.E. Fonseca7, F. Saraiva8
- Faculdade de Medicina da Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon; and Rheumatology Department, Unidade Local de Saúde Santa Maria, Centro Académico de Medicina de Lisboa, Lisbon, Portugal. raquel.campanilho@ulssm.min-saude.pt
- Faculdade de Medicina da Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon; and Rheumatology Department, Unidade Local de Saúde Santa Maria, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.
- Rheumatology Department, Unidade Local de Saúde da Região de Aveiro; Aveiro Rheumatology Research Center, Egas Moniz Health Alliance, Aveiro, Portugal.
- Faculdade de Medicina da Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon; and Rheumatology Department, Unidade Local de Saúde Santa Maria, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.
- Neuropathology Laboratory, Neurology Department, Unidade Local de Saúde Santa Maria, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.
- Neuropathology Laboratory, Neurology Department, Unidade Local de Saúde Santa Maria, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.
- Faculdade de Medicina da Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon; and Rheumatology Department, Unidade Local de Saúde Santa Maria, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.
- Rheumatology Department, Unidade Local de Saúde Santa Maria, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.
CER19442
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PMID: 43001848 [PubMed]
Received: 21/10/2025
Accepted : 06/05/2026
In Press: 05/11/2026
Abstract
OBJECTIVES:
Muscle ultrasound (US) has emerged as a valuable tool for assessing neuromuscular disorders, offering real-time imaging that enhances diagnostic accuracy and procedural safety. Ultrasound-guided needle muscle biopsy (UGNMB) optimises site selection, improves needle placement precision, and minimises complications compared to conventional biopsy techniques. This manuscript describes the UGNMB technique using a 14G guillotine-type semiautomatic biopsy needle, highlighting the continuous role of ultrasound in selecting the biopsy site and guiding the entire sample collection process.
METHODS:
A structured approach is followed, including patient preparation, pre-procedural assessment, and systematic ultrasound evaluation to ensure optimal needle trajectory, while avoiding tendons and neurovascular structures. This approach leverages ultrasound not only to assist in selecting the target muscle but also to guide the entire procedure in real-time.
RESULTS:
A previous study from our group demonstrated that UGNMB achieves a high diagnostic success rate with minimal discomfort. Continuous real-time visualisation allows dynamic needle tracking and more accurate targeting of viable muscle tissue while avoiding fascia, vessels, and areas of advanced damage.
CONCLUSIONS:
Continuous real-time ultrasound guidance thereby addresses a key limitation of conventional mark-and-biopsy approaches and potentially reduces false-negative sampling reported with traditional methods.
