Introduction to Trauma X-ray
Pathological fractures

Key points

  • Pathological fractures arise in bones weakened by disease
  • Osteoporosis is the most common cause of pathological fractures

High force is required to fracture a normal bone, but diseased bones may fracture as a result of low impact trauma. A fracture arising within abnormal bone is termed 'pathological.'

Osteoporosis is the commonest cause of pathological fractures.

Pathological fractures may also occur in bone weakened by benign or malignant, primary or secondary bone tumours.

Osteoporotic fracture example - Ulna

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Osteoporotic fracture example - Ulna

  • Generalised low bone density - compare the cortical thickness with the normal bone (inset)
  • There is a subtle impacted fracture of the ulna

Pathological fracture example - Multiple myeloma

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Pathological fracture example - Multiple myeloma

  • There is a transverse fracture of the humerus with anterior displacement and angulation
  • The bone appears 'moth-eaten'

Pathological fracture in benign bone lesion

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Pathological fracture in benign bone lesion

  • A fracture line passes through a well defined benign bone lesion - in this case a non-ossifying fibroma