In principle, every osteolytic focus in the femoral neck or the spine is at risk of a pathological fracture. Practical pointsĪ radiologist should mention the possibility of a pathological fracture if an osteolytic metastasis is seen. The abnormality in the bone may be due to metabolic diseases (such as osteoporosis, osteomalacia, or Paget’s disease), benign lesions, sarcomas, lymphoma, metastatic disease, and myeloma. Pathological fractures are feared by oncologists because they may cause immobilization of their patients, especially when the spine or lower extremities are affected. A pathologic fracture is defined as one occurring in abnormal bone. Pathological long bones fractures in patients with primary and metastatic bone tumours posses many difficulties to the most experienced surgeons. In addition, in adult patients, the avulsion of the femoral lesser trochanter should be considered a pathological fracture until proven otherwise 4. What is Pathological Fracture Pathological fracture (broken bone caused by disease) is found to be associated with 1,142 drugs and 493 conditions by eHealthMe. The most common location for pathological fractures are 4: Fragility fractures on the other hand, are acute fractures in osteoporotic patients due to a single event of minimal trauma. Important points: A force which is insufficient to break a normal bone may result in a. Insufficiency fractures are fractures due to multiple minor events causing a cumulative load on weakened osteoporotic bone. Paget disease, osteopetrosis), although the term insufficiency fracture is probably more correct 4. It can be used in the setting of generalized metabolic bone disease (e.g. The case suggests that focal osteolytic lesions of the ribs may regress over time and become scintigraphically inactive.The term pathological fracture is usually reserved for tumors, either benign or malignant, although it has been used in the setting of osteomyelitis. We conclude that osteoporosis should be included in the differential diagnosis of asymptomatic focal osteolysis of the ribs with rib fractures as a complication of acute cough. Five years later radiological and bone scintigraphy revealed resolution of the lesion.
The patient was observed between the year 20. Pharmacomedical treatments for osteoporosis were applied. What is a pathological fracture Spinal cord injuries cause life-altering paralysis of the limbs and place the patient at risk for long term complications. This is a patient with a pathologic pertrochanteric femur fracture from metastatic breast carcinoma. Final diagnosis was based on plain radiography, bone scan and bone densitometry. Evaluation of impending pathologic fractures. The authors describe multiple focal osteolytic lesions with rib fractures appearing in a pattern that could be confused with metastases. The diagnosis had to be approached as a diagnosis of exclusion since known causes of the osteolytic process had to be eliminated. The lesions were detected by chance after acute cough-induced rib fractures were seen on plain chest radiographs. This paper reports on a unique, previously unreported, successful outcome in the case of a patient with focal osteolytic lesions of the ribs as a first sign of osteoporosis.
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