Pathological Fractures

Question 1

What is a pathological fracture?

Answer 1

Occurs in abnormal bone due to insignificant injury.

Question 2

Give some broad causes of pathological fractures

Answer 2

1) Metastatic tumours e.g. breast, lung

2) Bone disease

3) Local benign conditions

4) 1ary malignant tumours

Question 3

What are 4 causes of bone disease causing pathological fractures?

Answer 3

1) Osteogenesis imperfecta

2) Osteoporosis

3) Metabolic bone disease

4) Paget’s disease

Question 4

What are 2 local benign conditions causing pathological fractures?

Answer 4

1) Chronic osteomyelitis

2) Solitary bone cyst

Question 5

What are 3 primary malignant tumours causing pathological fractures?

Answer 5

1) Chrondrosarcoma

2) Osteosarcoma

3) Ewing;s sarcoma

Question 6

What is the most common 1ary malignant bone tumour?

Answer 6

Osteosarcoma

Question 7

Who are osteosarcomas mainly seen in?

Answer 7

Children & adolescents

Question 8

Where do osteosarcomas most frequently occur?

Answer 8

In the metaphyseal region of long bones prior to epiphyseal closure:
- 40% occuring in the femur
- 20% in the tibia
- 10% in the humerus

Question 9

XR features of osteosarcoma?

Answer 9

Codman triangle (from periosteal elevation) and ‘sunburst’ pattern

Question 10

What mutation significantly increases the risk of osteosarcoma?

Answer 10

mutation of the Rb gene (hence association with retinoblastoma)

Question 11

Give 3 predisposing factors for an osteosarcoma

Answer 11

1) mutation of Rb gene

2) Paget’s disease of bone

3) radiotherapy

Question 12

What is Ewing’s sarcoma?

Answer 12

Small round blue cell tumour

Question 13

Who is Ewing’s sarcoma most frequently seen in?

Answer 13

Children & adolescents