This 36-years old had fever and right pelvic pain. Her MRI showed a focal lesion in the right iliac bone. She was sent for a biopsy.
The CT scan shows a well-defined osteolytic lesion with a sequestrum. The best route is through the posterior iliac crest, not from the sides. Going through bone minimises soft tissue trauma and allows a direct path into the lesion.
I used an 18G coaxial biopsy gun and tapped it into the lesion. This was histopath proven tuberculosis.