Evaluation of the Patient with an Impending or Actual Pathologic Fracture
Associated Medical Problems
When and How to Perform a Biopsy
Impending Pathologic Fractures
Treatment Options for Patients with Metastatic or Systemic Disease
Role of Adjuvant Radiation and Medical Treatment
Controversies and Future Directions
Treatment Options for Patients with Pathologic Fractures Through Primary Bone Tumors
Benign Bone Tumors
Malignant Bone Tumors
Summary and Key Points
FDG, fluorine-18-deoxyglucose; PET, positron emission tomography; CT, computed tomography.
Each patient’s situation is assessed by assigning a number (1, 2, or 3) to each aspect of his or her presentation (site, pain, lesion, and size) and then adding the numbers to obtain a total number to indicate the patient’s risk for fracture. Mirels’s data suggest that those patients whose total number is 7 or less can be observed, but those with a number of 8 or more should have prophylactic internal fixation.