Percutaneous image-guided needle biopsy of clavicle lesions: a retrospective study of diagnostic yield with description of safe biopsy routes in 55 cases

To assess the diagnostic yield and diagnostic accuracy of image-guided percutaneous needle biopsy of clavicle lesions and to analyse the diagnostic spectrum of clavicular lesions referred to a tertiary musculoskeletal oncology centre. To further describe safe biopsy routes for biopsy of the unique clavicle bone. A retrospective review of all patients who underwent an image-guided clavicle biopsy during the period from August 2006 to December 2013. A total of 52 patients with 55 consecutive biopsies were identified and included in the study. Image-guided percutaneous biopsy was performed using CT (n = 38) or ultrasound (n = 17). There were 23 males and 29 females, with a mean age of 40 years (range 2 to 87 years). Forty-six of the 55 biopsies (83.6 %) yielded a diagnostic sample and 9 (16.4 %) were non-diagnostic. Thirty of 46 (65.2 %) lesions were malignant and 16 (34.8 %) were benign/non-neoplastic. The most common malignant lesions were metastases, 22 of 30 (73.3 %), followed by primary tumours in 8 of 30 (26.7 %). The most common benign/non-neoplastic lesion was chronic recurrent multifocal osteomyelitis (4 of 16, 25 %) followed by Langerhans cell histiocytosis, epithelioid haemangioma and osteomyelitis (each with 2 of 16, 12.5 %). There was complete agreement between the needle and surgical histology specimen in 12 of 13 subjects (92.3 %). No post-biopsy complications were reported. Image-guided percutaneous biopsy has high diagnostic yield and accuracy and the described approaches are a safe means of biopsy for clavicle lesions.