Mirel's criteria is developed for the evaluation of
Mirel's Criteria For Risk of Pathological Fracture: 1 Mirel's developed a scoring system based on, the presence or absence of pain,the size, location, and radiographic appearance of the lesion to quantify the risk of impending pathological fracture in malignant lesion 2 So patients with maximum risk of pathological fracture are having lytic peritrochantric lesion involving >2/3 diameter with severe pain 3 Patients with < 7 score are observed, but those with 8 or more should have prophylactic internal fixation. Pathological Fractures may occur even with normal stresses if the bone has been weakened by a change in its structure Causes: osteoporosis, osteogenesis imperfecta , Paget's disease, bisphosphonate therapy) or through a lytic lesion (e.g. a bone cyst or a metastasis). FDG-PET CT is the gold standard for bone Metastasis. It occurs in abnormal bones. Mostly in elderly people. Fractures can be single or multiple occurs after tril injury. Pain in the case of a pathological fracture usually precedes the fracture. Pain can occur at the site before the fracture
Risk of fatigue fracture
Severity of osteoporosis
Risk of pathological fracture
Severity of neurological defecit
Fracture Management