Mirels criteria for pathologic fracture risk
Fracture risk in bone metastases, to guide prophylactic fixation.
Inputs
0 of 4Site
Pain
Lesion
Size (fraction of cortex)
When to use
- Long-bone metastatic lesions.
Pearls and pitfalls
- 9 or higher: prophylactic fixation; 8: clinical judgment; 7 or lower: radiation and observation.
Why use
Standard orthopedic oncology tool.
| Criterion | Points |
|---|---|
| Site: Upper limb | +1 |
| Lower limb | +2 |
| Peritrochanteric | +3 |
| Pain: Mild | +1 |
| Moderate | +2 |
| Functional (with weight bearing) | +3 |
| Lesion: Blastic | +1 |
| Mixed | +2 |
| Lytic | +3 |
| Size (fraction of cortex): Under 1/3 | +1 |
| 1/3 to 2/3 | +2 |
| Over 2/3 | +3 |