link
Bookmarks
Pathologic Fracture
Kirkland W. Davis, MD, FACR; Andrew Sonin, MD, FACR
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Log inSubscribe
0
12
19
0

KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Pathologic fracture (path fx)
            • Definitions

              • Fracture through abnormal osseous lesion
                • Tumor
                • Infection
                • Postsurgical
                • Metabolic
                • Congenital

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        • Reporting Tips

                                          Selected References

                                          1. Chakarun CJ et al: Giant cell tumor of bone: review, mimics, and new developments in treatment. Radiographics. 33(1):197-211, 2013
                                          2. Hechmati G et al: Cost of skeletal-related events in European patients with solid tumours and bone metastases: data from a prospective multinational observational study. J Med Econ. 16(5):691-700, 2013
                                          3. Probst S et al: Atypical bisphosphonate-associated subtrochanteric and femoral shaft stress fractures: diagnostic features on bone scan. Clin Nucl Med. 38(5):397-9, 2013
                                          4. Steensma M et al: Trends in the surgical treatment of pathologic proximal femur fractures among musculoskeletal tumor society members. Clin Orthop Relat Res. 471(6):2000-6, 2013
                                          5. Chan SS et al: Subtrochanteric femoral fractures in patients receiving long-term alendronate therapy: imaging features. AJR Am J Roentgenol. 194(6):1581-6, 2010
                                          6. Kurup AN et al: Ablation of skeletal metastases: current status. J Vasc Interv Radiol. 21(8 Suppl):S242-50, 2010
                                          7. Bosita RV et al: Avascular necrosis of lumbar facet joints associated with bilateral facet fractures. Spine J. 9(6):e1-4, 2009
                                          8. Kim MS et al: Prognostic effect of pathologic fracture in localized osteosarcoma: a cohort/case controlled study at a single institute. J Surg Oncol. 100(3):233-9, 2009
                                          9. Atesok K et al: Treatment of pathological humeral shaft fractures with unreamed humeral nail. Ann Surg Oncol. 14(4):1493-8, 2007
                                          10. Bramer JA et al: Do pathological fractures influence survival and local recurrence rate in bony sarcomas? Eur J Cancer. 43(13):1944-51, 2007
                                          11. Deheshi BM et al: Joint salvage for pathologic fracture of giant cell tumor of the lower extremity. Clin Orthop Relat Res. 459:96-104, 2007
                                          12. Shenoy R et al: Tumours of the hand presenting as pathological fractures. Acta Orthop Belg. 73(2):192-5, 2007
                                          13. Erly WK et al: The utility of in-phase/opposed-phase imaging in differentiating malignancy from acute benign compression fractures of the spine. AJNR Am J Neuroradiol. 27(6):1183-8, 2006
                                          14. James SL et al: Atraumatic avulsion of the lesser trochanter as an indicator of tumour infiltration. Eur Radiol. 16(2):512-4, 2006
                                          15. Papagelopoulos PJ et al: Advances and challenges in diagnosis and management of skeletal metastases. Orthopedics. 29(7):609-20; quiz 621-2, 2006
                                          16. Snyder BD et al: Predicting fracture through benign skeletal lesions with quantitative computed tomography. J Bone Joint Surg Am. 88(1):55-70, 2006
                                          17. Fayad LM et al: Distinction of long bone stress fractures from pathologic fractures on cross-sectional imaging: how successful are we? AJR Am J Roentgenol. 185(4):915-24, 2005
                                          18. Weber KL et al: An approach to the management of the patient with metastatic bone disease. Instr Course Lect. 53:663-76, 2004
                                          19. Bacci G: Pathologic fracture in osteosarcoma. J Bone Joint Surg Am. 85-A(9):1848; author reply 1848-9, 2003
                                          20. Frassica FJ et al: Evaluation and treatment of metastases to the humerus. Clin Orthop Relat Res. (415 Suppl):S212-8, 2003
                                          21. McVey MJ et al: Pathologic fracture of metacarpal enchondroma: case study and differential diagnosis. J Manipulative Physiol Ther. 25(5):340-4, 2002
                                          22. Spuentrup E et al: Diffusion-weighted MR imaging for differentiation of benign fracture edema and tumor infiltration of the vertebral body. AJR Am J Roentgenol. 176(2):351-8, 2001
                                          23. Wai EK et al: Pathologic fractures of the proximal femur secondary to benign bone tumors. Clin Orthop Relat Res. (393):279-86, 2001
                                          24. Ablove RH et al: Early versus delayed treatment of enchondroma. Am J Orthop (Belle Mead NJ). 29(10):771-2, 2000
                                          25. Natarajan MV et al: Limb salvage surgery for pathological fractures in osteosarcoma. Int Orthop. 24(3):170-2, 2000
                                          26. Ishiguro N et al: The surgical treatment of a haemophilic pseudotumour in an extremity: a report of three cases with pathological fractures. Haemophilia. 4(2):126-31, 1998
                                          27. Lingg GM et al: Insufficiency and stress fractures of the long bones occurring in patients with rheumatoid arthritis and other inflammatory diseases, with a contribution on the possibilities of computed tomography. Eur J Radiol. 26(1):54-63, 1997
                                          28. Hillemanns M et al: Malignant lymphoma. Skeletal Radiol. 25(1):73-5, 1996
                                          29. Wall JE et al: Fractures in children treated with radiotherapy for soft tissue sarcoma. Orthopedics. 19(8):657-64, 1996
                                          30. Dijstra S et al: Impending and actual pathological fractures in patients with bone metastases of the long bones. A retrospective study of 233 surgically treated fractures. Eur J Surg. 160(10):535-42, 1994
                                          31. Townsend PW et al: Impact of postoperative radiation therapy and other perioperative factors on outcome after orthopedic stabilization of impending or pathologic fractures due to metastatic disease. J Clin Oncol. 12(11):2345-50, 1994
                                          32. Haentjens P et al: Evaluation of impending fractures and indications for prophylactic fixation of metastases in long bones. Review of the literature. Acta Orthop Belg. 59 Suppl 1:6-11, 1993
                                          33. Rock MG: Metastatic lesions of the humerus and the upper extremity. Instr Course Lect. 41:329-33, 1992
                                          34. Walker LG et al: Pathologic fracture of the proximal ulna through a bone graft donor site. J Hand Surg Am. 15(5):781-4, 1990
                                          35. Bertin KC et al: Isolated fracture of the lesser trochanter in adults: an initial manifestation of metastatic malignant disease. J Bone Joint Surg Am. 66(5):770-3, 1984
                                          Related Anatomy
                                          Loading...
                                          Related Differential Diagnoses
                                          Loading...
                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Pathologic fracture (path fx)
                                                    • Definitions

                                                      • Fracture through abnormal osseous lesion
                                                        • Tumor
                                                        • Infection
                                                        • Postsurgical
                                                        • Metabolic
                                                        • Congenital

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              • Image Interpretation Pearls

                                                                                • Reporting Tips

                                                                                  Selected References

                                                                                  1. Chakarun CJ et al: Giant cell tumor of bone: review, mimics, and new developments in treatment. Radiographics. 33(1):197-211, 2013
                                                                                  2. Hechmati G et al: Cost of skeletal-related events in European patients with solid tumours and bone metastases: data from a prospective multinational observational study. J Med Econ. 16(5):691-700, 2013
                                                                                  3. Probst S et al: Atypical bisphosphonate-associated subtrochanteric and femoral shaft stress fractures: diagnostic features on bone scan. Clin Nucl Med. 38(5):397-9, 2013
                                                                                  4. Steensma M et al: Trends in the surgical treatment of pathologic proximal femur fractures among musculoskeletal tumor society members. Clin Orthop Relat Res. 471(6):2000-6, 2013
                                                                                  5. Chan SS et al: Subtrochanteric femoral fractures in patients receiving long-term alendronate therapy: imaging features. AJR Am J Roentgenol. 194(6):1581-6, 2010
                                                                                  6. Kurup AN et al: Ablation of skeletal metastases: current status. J Vasc Interv Radiol. 21(8 Suppl):S242-50, 2010
                                                                                  7. Bosita RV et al: Avascular necrosis of lumbar facet joints associated with bilateral facet fractures. Spine J. 9(6):e1-4, 2009
                                                                                  8. Kim MS et al: Prognostic effect of pathologic fracture in localized osteosarcoma: a cohort/case controlled study at a single institute. J Surg Oncol. 100(3):233-9, 2009
                                                                                  9. Atesok K et al: Treatment of pathological humeral shaft fractures with unreamed humeral nail. Ann Surg Oncol. 14(4):1493-8, 2007
                                                                                  10. Bramer JA et al: Do pathological fractures influence survival and local recurrence rate in bony sarcomas? Eur J Cancer. 43(13):1944-51, 2007
                                                                                  11. Deheshi BM et al: Joint salvage for pathologic fracture of giant cell tumor of the lower extremity. Clin Orthop Relat Res. 459:96-104, 2007
                                                                                  12. Shenoy R et al: Tumours of the hand presenting as pathological fractures. Acta Orthop Belg. 73(2):192-5, 2007
                                                                                  13. Erly WK et al: The utility of in-phase/opposed-phase imaging in differentiating malignancy from acute benign compression fractures of the spine. AJNR Am J Neuroradiol. 27(6):1183-8, 2006
                                                                                  14. James SL et al: Atraumatic avulsion of the lesser trochanter as an indicator of tumour infiltration. Eur Radiol. 16(2):512-4, 2006
                                                                                  15. Papagelopoulos PJ et al: Advances and challenges in diagnosis and management of skeletal metastases. Orthopedics. 29(7):609-20; quiz 621-2, 2006
                                                                                  16. Snyder BD et al: Predicting fracture through benign skeletal lesions with quantitative computed tomography. J Bone Joint Surg Am. 88(1):55-70, 2006
                                                                                  17. Fayad LM et al: Distinction of long bone stress fractures from pathologic fractures on cross-sectional imaging: how successful are we? AJR Am J Roentgenol. 185(4):915-24, 2005
                                                                                  18. Weber KL et al: An approach to the management of the patient with metastatic bone disease. Instr Course Lect. 53:663-76, 2004
                                                                                  19. Bacci G: Pathologic fracture in osteosarcoma. J Bone Joint Surg Am. 85-A(9):1848; author reply 1848-9, 2003
                                                                                  20. Frassica FJ et al: Evaluation and treatment of metastases to the humerus. Clin Orthop Relat Res. (415 Suppl):S212-8, 2003
                                                                                  21. McVey MJ et al: Pathologic fracture of metacarpal enchondroma: case study and differential diagnosis. J Manipulative Physiol Ther. 25(5):340-4, 2002
                                                                                  22. Spuentrup E et al: Diffusion-weighted MR imaging for differentiation of benign fracture edema and tumor infiltration of the vertebral body. AJR Am J Roentgenol. 176(2):351-8, 2001
                                                                                  23. Wai EK et al: Pathologic fractures of the proximal femur secondary to benign bone tumors. Clin Orthop Relat Res. (393):279-86, 2001
                                                                                  24. Ablove RH et al: Early versus delayed treatment of enchondroma. Am J Orthop (Belle Mead NJ). 29(10):771-2, 2000
                                                                                  25. Natarajan MV et al: Limb salvage surgery for pathological fractures in osteosarcoma. Int Orthop. 24(3):170-2, 2000
                                                                                  26. Ishiguro N et al: The surgical treatment of a haemophilic pseudotumour in an extremity: a report of three cases with pathological fractures. Haemophilia. 4(2):126-31, 1998
                                                                                  27. Lingg GM et al: Insufficiency and stress fractures of the long bones occurring in patients with rheumatoid arthritis and other inflammatory diseases, with a contribution on the possibilities of computed tomography. Eur J Radiol. 26(1):54-63, 1997
                                                                                  28. Hillemanns M et al: Malignant lymphoma. Skeletal Radiol. 25(1):73-5, 1996
                                                                                  29. Wall JE et al: Fractures in children treated with radiotherapy for soft tissue sarcoma. Orthopedics. 19(8):657-64, 1996
                                                                                  30. Dijstra S et al: Impending and actual pathological fractures in patients with bone metastases of the long bones. A retrospective study of 233 surgically treated fractures. Eur J Surg. 160(10):535-42, 1994
                                                                                  31. Townsend PW et al: Impact of postoperative radiation therapy and other perioperative factors on outcome after orthopedic stabilization of impending or pathologic fractures due to metastatic disease. J Clin Oncol. 12(11):2345-50, 1994
                                                                                  32. Haentjens P et al: Evaluation of impending fractures and indications for prophylactic fixation of metastases in long bones. Review of the literature. Acta Orthop Belg. 59 Suppl 1:6-11, 1993
                                                                                  33. Rock MG: Metastatic lesions of the humerus and the upper extremity. Instr Course Lect. 41:329-33, 1992
                                                                                  34. Walker LG et al: Pathologic fracture of the proximal ulna through a bone graft donor site. J Hand Surg Am. 15(5):781-4, 1990
                                                                                  35. Bertin KC et al: Isolated fracture of the lesser trochanter in adults: an initial manifestation of metastatic malignant disease. J Bone Joint Surg Am. 66(5):770-3, 1984