Pathological Fracture Flashcards
What is a pathological fracture?
a fracture associated with bone weakness as a result of a tumour or bone disease
Give the most common sites of bone metastasis from most to least common:
- Spine
- Pelvis
- Ribs
- Skull
- Long bones
Give 5 primary cancers known to cause bone metastases:
- Breast
- Prostate
- Lung
- Kidney
- Thyroid
Give 4 presentations associated with bone metastases:
1) bone pain
2) pathological fractures
3) hypercalcaemia
4) raised ALP
What are the 3 categories of bone metastasis?
- Blastic
- Lytic
- Mixed
What is blastic bone metastasis?
where the tumour fills the bone with extra cells and stimulates the bone to proliferate
What is lytic bone metastasis?
Where the tumour destroys bone material
What is the name of the scoring system used to calculate risk associated with a pathological fracture and identify who would benefit from prophylactic fixataion?
Mirel scoring system
What are the 4 points of the criteria in the Mirel Scoring System?
- Location - highest risk associated with trochanteric region
- Amount of bone diameter affected
- Is the lesion lytic or blastic - highest risk associated with lytic
- Pain severity
Where is the trochanteric reigion?
The trochanteric region refers to the bony protrusion located in the upper extremity of the femur
What score out of the total 12 would indicate the need for prophylactic fixation using the Mirel Scoring System?
9 +
What is prophylactic fixation?
This procedure is done by inserting metal into the bone in order to strengthen it well before it breaks
Give 2 investigations for bone metastases:
1) isotope bone scan
2) myeloma scan - CT/ PET-CT/ MRI (if the lesions are lytic)
Name 3 primary malignant tumours that can cause pathological fractures:
1) chondrosarcoma
2) osteosarcoma
3) Ewing’s tumour
Give 4 non-tumour related causes of pathological fractures:
1) osteogenesis imperfecta
2) osteoporosis
3) metabolic bone disease
4) Paget’s disease
