Auscultation of the skull in the detection of osteolytic lesions.

Abstract

WHILE examining a patient with a large osteolytic skull lesion, we noted a difference in the quality of the voice on auscultation of the skull. The patient was a sixty-year-old woman previously seen because of metastatic carcinoma to the cervical vertebras. Cervical laminectomy and biopsy had confirmed this diagnosis. The primary tumor site was not ascertained. Skull roentgenograms demonstrated an osteolytic, presumably metastatic, lesion in the left parietal region (Fig. 1). The diaphragm of the stethoscope was used. The patient was asked to repeat the phrase ninety-nine. The voice was clearer and more highly pitched over the left parietal bone. . . .