My biopsy was pretty uneventful. I had mine in my right deltoid. The surgeon I worked for at the time did it for me. He went pretty deep and didn't want to use local, so he did it under general anesthesia. I took the next day off of work but was fine after that. I've heard some folks say that they've had a heck of a time with it when they have it done in hamstrings or quads.

Good luck!

Angie,
They did my biopsy in my left quadricept or upper thigh. I was also put to sleep. When I woke up I required pain pills and I was very sore for at least a week. Without the pain pills for that week I wouldn't have made it.
Hugs,
Lauren

I had to have 2 biopsies because one was mishandled by the OR staff. Both were done under general ansthesia (at my request) and taken from from my quads because that's where I had the most weakness initially. Both times I had severe pain with standing or walking for just a few days and numbness around the incision for about a year. The incision became infected after the first surgery, and the infection spread deep into the surrounding skin. I had extreme redness, pulsating pain, and fever for several days but cleared easily with oral antibiotics.

I know this doesn't sound good, and I don't mean to scare you. Like wrknprogress, many people have little or no discomfort or complications, and I hope you're one of them.

Just a few tips/facts that might be helpful: 1)Don't let anyone biopsy the same muscle that was used first for EMG testing; the needle electrode for EMG can cause changes in the muscle. 2)Inflammation and damage is commonly found in patches within a muscle, so if they don't sample a "bad" patch the biopsy could be normal; ask your doc about doing an MRI first to find locate a place that has the most inflammation. 3) If your biopsy is negative for myositis, demand further evaluation to find out what's causing your problems; don't let anyone tell you it's all in your head. And 4) Don't get too worried about it; even with complications it wasn't the worst medical procedure I've had. Good luck!
~Lucky

One more thing... Try to get the biopsy scheduled as soon as possible because the longer you're on high dose prednisone, the more likely it will be that the biopsy doesn't show inflammation and tissue damage needed for the diagnosis. Your rheumy should have the ability to get it done quickly, and you don't need to worry about the surgeon because it doesn't take much skill to do the biopsy. It does take skill to read it, though. Best of luck again!

I had my done on the right deltoid and under general anesthesia...the neurosurgeon took two chuncks of tissue...I would insist on general anesthesia....I had much pain after coming out from under the anesthesia but the recovery room worked immediately to get my pain under control...I had to take pain meds regularly for several days...Two things that helped me: 1) Prop a towel or something similar under your shoulder or leg for support when lying down and 2) I used a wrapped ice pack on the biopsied area on the second day, which seemed to keep the soreness and inflammation down...

Good luck! Hope things go well for you!

Maggie

Lucky~

I was told that the biopsy couldn't be done once prednisone had been started. If one is on prednisone, you have to come off of it for an extended period of time before the biopsy can be done was my understanding. My treatment was held up because of the biopsy. It was only a week, but still. In addition...the doctor who did my EMG actually left my deltoid alone because knew they would want to do the biopsy asap. My timeline was ridiculously fast. EMG, rheumy two days later, muscle biopsy four days later, prednisone four days after that.

Hi wrkinprogress!
I also had a really fast testing schedule and started treatment quickly. It's certainly best to have the biopsy done before treatment is even started; however, my 2nd one was done after I was on prednisone for almost 6 months. The rheumy justified it by saying that if it's positive, then there's no question that I have DM. If it's negative, though, the findings would be inconclusive.

I agreed to do it again and had text-book findings for DM. I'm not sure I would have agreed with the rheumy if I knew then what I do now. They could have diagnosed DM by my skin biopsy and symptoms alone. So you live and learn, but I do hope some others can benefit from the mistakes I lived through.
~Lucky

Like the others have said, it isn't especially fun but it isn't too bad either. I had mine done in my left quad. My incision is about 2" long. I had it done on a Friday with conscious sedation (Versed). (Love that) They also put a nerve block in it so I really didn't feel much for about 24 hours. Not too shabby. Because it was out of my quad, walking was limpy and it hurt when I engaged my muscle but I was okay to go to a neighborhood BBQ on Monday evening. I was back to work on Tuesday. I had also been on Prednisone for 6 weeks because my Neurosurgeon was an ass and wouldn't see me for several weeks. He was mad that my Neurologist (who worked in the same office) asked him to fit me in that week. So I waited 5 weeks for an appointment. I still got results but it is probably like Lucky said - If you have it, you absolutely do. If it comes back inconclusive - well you just don't know.

Good luck. Be sure to ask for some sort of sedation besides a local. I highly recommend the nerve block too.

(plagiarized from lexisgirl)
"Like the others have said, it isn't especially fun but it isn't too bad either. I had mine done in my left quad. My incision is about 2" long. I had it done on a Friday with conscious sedation (Versed). (Love that) They also put a nerve block in it so I really didn't feel much for about 24 hours. Not too shabby. Because it was out of my quad, walking was limpy and it hurt when I engaged my muscle"

Just like mine only I was on 60 prednizone for a week prior to the biopsy. Mine came back inconclusive showing no inflammation. Drs. said it was because of the steroid treatment. Why did you bother with it, I asked? They said just in case it showed something. Duhhh!!! It comes back to the old adage...never ask a surgeon if you need surgery :(

I think all of you who had your biopsies done under anesthesia are so lucky. I had mine in my bicep with only a latacaine shot which just numbs the skin. They never ever offered anesthesia and I had no idea it was going to feel like that. I found it to be very painful and I acted like a complete baby. I don't mean to scare you Angie, I just want you to insist on anesthesia, I will never do one again without it. They took 4 samples and each time I swore more and more. The neurologist said I was in the top 10 for drama that he has ever seen, my boyfriend almost punched him! I also held off on the prednisone until the biopsy, it was a ten day wait and it was hard, but I am glad that I had a conclusive test. My Rheumatologist gave me a choice on that and I am glad I made that choice. For a day it felt like I was beat up and I couldn't use that arm, then each day it got better for a bout 2 weeks I was very aware of it and had to really work to stretch it back out again because not using it and the disease was starting to make it contracted, I was not able to straighten it out. But it all worked out and it's behind me now and I lived to talk about it. Maybe I am a drama queen, I thought I had a high tolerance for pain, but who really knows what anyones pain feels like. i think I have hypersensitive nerve endings. I wish you luck dear Angie.
Love and Light,
Maruska

My biopsy was done in the left thigh after an MRI and i was on high doses of pred at the time, was done under a local with a nerve blocker. They took 3 plugs of muscle and my scar is about 3 inches long. It was sore for about a week afterward especially getting off the toilet seat. Mine was conclusive and tied in with all the other test results that i had at the time.
I hope it all goes well for you.

Take Care

Ness

Luckybee's posts sum up what there is to know about muscle biopsy but here are my thoughts:
Effectively, taking prednisone before the biopsy can skew the results. Same goes for EMG sites. Usually, the MRI will tell the surgeon where to do the biopsy. Personally, I chose the left deltoid because being right-handed I knew I would use my left less. I knew that quadriceps would prove painful because you really have to use these muscles in day-to-day life.
I had local ansthesia for the procedure; they took quite a big chunk. It was not very painful during the following days but I still have discomfort (even after 2 years). My osteopath worked on the scar and things are better now.
The interpretation of the tissue is the crucial aspect of the biopsy. You need a competent pathologist who knows about this condition. The complete analysis can take some three weeks. My biopsy was done to determine whether it was PM or IBM; PM is treatable, IBM is not.
Good luck!

Levek,
I think you made a good choice for a beginner! I remember reading an article about muscle biopsies for myositis where the author recommended using a deltoid because it's much smaller than the quads and so the chance of hitting the right spot is greater.

That sounds logical to me and would be a particularly good strategy if an MRI can't be done first for whatever reason. Don't you wish we all knew at the beginning what we know now?
~Lucky

Hi Angie
I had a biopsy done about 6 weeks ago. They took a slice of muscle from my upper left arm. I had to have an anaesthetic as local infiltration could have affected the results. My arm was very sore for about 6 days afterwards. Putting dishes in the drainer was difficult, but managable with regular Panadol. Mind you with the muscle weakness from PM it was sore anyway. Good luck with your biopsy and take extra care of yourself at this time. I will be thinking of you

I had one done in July. It was my saving grace. I am still in a lot of pain and taking Prednisone. I am suppose to be on Cellcept, but had to stop until my lab was done. My surgeon took mine from my good thigh. My muscles had gotten so weak that I was unable to stand or walk and the pain in my back would not allow me to lie down flat.