What is a bone marrow aspirate and why is it so painful? Blood
cells are manufactured in the bone marrow space and examination
of these cells in myeloma is performed to identify an increase
in the number of plasma cells which is one of the cardinal
features used to confirm the diagnosis. In order to obtain these
cells for examination the clinician needs to perform a bone
marrow aspirate. The thin “skin” that coats the bone surface and
carries the small nerves responsible for carrying sensation and
pain, is anaesthetised using local anaesthetic. A special needle
is then inserted into the bone. Marrow is withdrawn with a
syringe attached to the needle, like a blood test. When we are
born, most of our bones contain marrow, but as we get older the
marrow in our limbs is replaced by fat and the majority of the
marrow resides in the spinal vertebrae, ribs, pelvis and breast
bone. Samples are normally taken from the pelvis or breastbone
and only very rarely from the spine. Although aspiration is
uncomfortable, the p