Bone fracture (pathological)

Keywords: Pathological fracture, Fracture, Fracture pathological, Bone fracture - pathological

Causes

Appropriate Tests

 

Careful clinical assessment and diagnostic imaging may indicate the likely underlying cause.

Calcium, Phosphate, Albumin, Protein, Protein electrophoresis, Alkaline phosphatase, Full blood count, Blood film, C-Reactive protein, Bence Jones protein urine.

Fine needle aspiration biopsy, Tissue biopsy, Bone biopsy (fracture site) or Bone marrow biopsy (aspiration and trephine), as appropriate.

Metastatic carcinoma, especially

See also Leucoerythroblastic anaemia.

  • Breast

Breast biopsy for histological examination.

  • Lung

Lung biopsy for histological examination.

  • Prostate

Prostate specific antigen; Acid phosphatase is less useful. Prostate needle biopsy for histological examination.

  • Thyroid

See under Thyroid nodule/cyst.

  • Kidney

See under Renal mass.

Plasma cell myeloma

Blood or urine examination for abnormal circulating proteins  (eg Bence Jones protein urine)

Benign bone tumour, cyst

Bone biopsy for histological examination.

Sarcoma

  • Osteogenic sarcoma
  • Chondrosarcoma
  • Ewing's 'sarcoma'

Bone biopsy for histological examination.

Osteoporosis

Bone density testing

Osteomalacia

 

Paget's disease of the bone

Tissue biopsy for histological examination.

Renal osteodystrophy

Creatinine, Urea, Aluminium, Parathyroid hormone.

See under Renal failure

Hyperparathyroidism

Parathyroid hormone

Osteogenesis imperfecta

Consult pathologist.

Hypophosphatasia

Amino acids urine (ethanolamine phosphate). Alkaline phosphatase.