Bone fracture (pathological)

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


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.


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

Bone biopsy for histological examination.


Bone density testing



Paget's disease of the bone

Tissue biopsy for histological examination.

Renal osteodystrophy

Creatinine, Urea, Aluminium, Parathyroid hormone.

See under Renal failure


Parathyroid hormone

Osteogenesis imperfecta

Consult pathologist.


Amino acids urine (ethanolamine phosphate). Alkaline phosphatase.


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