Ultrasonographic detection and guided biopsy of thoracic osteolysis

Eighty-six osteolytic lesions of the rib cage were examined by means of conventional radiography and ultrasonography. The ultrasonographic criteria of osteolysis are described. Only 1 rib metastasis was missed by ultrasonography while 13 lesions were not detected by x-ray film. Of 63 ultrasonographically guided biopsies, 62 resulted in the final diagnosis; complications were not observed. The results recommend ultrasonographic examination combined with guided biopsy as the first diagnostic step, if a metastasis of the rib cage is suspected after physical examination or after a pathologic bone scan.