Curriculum · Musculoskeletal / Orthopedic / Rheumatology
Pathological fracture
What it is
A pathological fracture is a fracture that follows trivial trauma in an abnormally looking bone. On the x-ray the fracture runs through a lytic lesion, and the bone itself is abnormal with thinning.
How it presents
The story is long-standing pain in the limb, then a fracture after trivial trauma. A man of 75 with 6 months of arm pain who suddenly felt pain in the arm and was not able to move it while playing with a small child fits the pattern; the x-ray in that setting was a pathological fracture of the mid-shaft of the humerus, and the diagnosis was metastatic bone disease with osteoporosis.