What is the preferred site for bone marrow aspiration and biopsy in adults?

The iliac crest is the preferred site for bone marrow aspiration and biopsy in adults due to its anatomical advantages and accessibility. This area has a large enough structure to allow for effective sampling of the bone marrow, which is crucial for the diagnosis of various hematological conditions. The iliac crest provides an abundant and easily accessible source of hematopoietic tissue while minimizing the risk of damage to surrounding structures and ensuring patient comfort.

In contrast, while the sternum can also be used for bone marrow procedures, it is not as commonly preferred as the iliac crest because of potential complications, such as the risk of injuring the chest wall or major vessels. The tibia, although sometimes used in pediatric cases, is less ideal in adults since the cortical bone is denser and can make aspiration more challenging. The spinous processes of a vertebra are not typically used for this purpose due to the difficulty in accessing sufficient marrow and the higher risk of complications in the spinal region. Therefore, the iliac crest remains the standard choice for optimal safety and efficacy in adult bone marrow examinations.