Dr. George Orloff, MD

Fine needle aspiration (FNA) and core needle biopsy (CNB) are sometimes image-guided, where a mammogram, ultrasound, or MRI helps direct the physician performing the needle extraction.

Fine needle aspiration, the most common biopsy method, generally requires few patient preparations. It is recommended patients avoid using lotion, deodorant, and perfume prior to their biopsy procedure. FNA biopsy is performed with local anesthesia (topical numbing cream) and typically has a quick recovery, but patients may experience soreness for a few days. Core needle biopsy extracts slightly more tissue than an FNA biopsy.

Open (surgical) biopsy is more invasive and requires general anesthesia, where patients are put to sleep during the procedure. Patients must fast prior to the surgery. After the biopsy is performed, patients are monitored in a recovery room for a time before being discharged, when they will need someone else to provide transportation.

Although some may consider breast biopsy to be a simple procedure, it can catch critical issues - particularly breast cancer - that impact wellness. If a breast biopsy reveals an underlying condition like life-threatening cancer, patients can receive the diagnosis and medical treatment that is necessary for their long-term health.

Joint problems include bursitis and arthritis. Bursitis is the inflammation of a fluid-filled sac cushion on the outside of a joint, causing symptoms including pain and swelling. Arthritis is the inflammation and damage of a joint due to wear and tear or disease. There are several treatments for arthritis, but if the damage progresses far enough, joint replacement may be necessary. In joint replacement, a metal or plastic implant is surgically placed within the joint to make movement easier.

Bone problems include scoliosis, fractures, and osteoporosis. Scoliosis is a curvature of the spine, making the normally straight spine look like a 'C' or 'S.' It is treated with braces or surgery. Osteoporosis is a disease that causes bones to weaken and break easily. It's most common in women, especially older women. Fully half of all women over 65 have osteoporosis. Fractures are any break in the bone. They can be a simple crack or a severe and complicated shatter. Osteoporosis causes fractures in people who have it, but other causes are trauma (such as a fall) or overuse.

Tendon and ligament problems most often result from injury or overuse. Two good examples are ligament tears and tendonitis. The most common ligament tear is the ACL tear in the knee. This ligament supports and stabilizes the knee and is most often torn during sports activities. Tendonitis happens when a tendon, which connects muscles and bones together, becomes irritated and inflamed. This happens most often in older patients who push their bodies too far, leading to pain and swelling. Treatment for both tendon and ligament problems usually includes rest, ice, and supporting the area to let it heal.

Pain and numbness problems can be caused by overuse, disease, an injury, or a compressed nerve. Lower back pain and carpal tunnel syndrome are two of the most common conditions patients encounter. Lower back pain may be caused by sore muscles that have been overworked, or an injury to the disks separating the vertebrae in the spine. Lower back pain usually goes away on its own within a few days, but it may require medical treatment depending on the cause. Carpal tunnel syndrome occurs when the nerve at the base of the palm becomes trapped or pinched. Symptoms include tingling, pain, numbness, or weakness in the hand. Treatment involves rest and sometimes steroid injections.

Because the musculoskeletal system involves so much of the body, problems here can be incredibly varied in their type and severity. Some musculoskeletal problems will go away on their own or only require rest, while others may require medication, physical therapy, or even surgery.

Pancreatectomy can be done by open or minimally invasive surgery. During a laparoscopic pancreatectomy, the surgeon will use tiny incisions to insert a thin tube with a camera, or laparoscope, into the abdomen. Open surgery, or a laparotomy, is performed through a larger incision on the abdomen. If additional organs are removed, some procedures may require that the small intestine be reconnected to the stomach.

The hospital for pancreatectomy stay may be between 1-3 weeks. Generally, laparoscopic surgeries require shorter recovery periods. Whether patients undergo an open or laparoscopic procedure is determined by factors such as their condition and the extent of their procedure. For example, open surgery tends to be more common for distal pancreatectomies. If patients have difficulty eating, they may require a nasogastric tube, inserted through the nose, to carry food to their stomachs. A catheter can be inserted into the bladder if patients have trouble urinating. Full recovery may take about two months.