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April 16, 1982

Diagnosis and Management of Lytic Lesions in Bone

Author Affiliations

Veterans Administration Medical Center Medical College of Georgia Augusta

JAMA. 1982;247(15):2099. doi:10.1001/jama.1982.03320400019020

To the Editor.—  In reference to the article by Carrera et al to fluoroscopic percutaneous bone biopsy (1981; 246:884), several comments should be made.The authors are to be commended for the use of this simple technique that has been in vogue for a number of years, as is documented in their bibliography. One notes that their description of ten patients in one year's time from two major teaching hospitals does not represent a large series and would indicate that the authors are rather conservative in the use of percutaneous bone biopsy. However, we think that a multidisciplinary approach of surgeon, pathologist, and radiologist, rather than solely radiological consultation, should be used in the diagnosis and management of lytic lesions in bone, particularly those involving long bones as advocated by Evarts1 and Ottolenghi.2 One reason is that consideration should be given to internal fixation with impending pathological fractures