Pathologic Fractures

Pathologic fracture refers to condition when a bone is broken by abnormally weak force or by no force at all. This condition is most often caused by either excessive bone decalcification or by local metastatic process.



This is a common condition in patients of advanced age, it typically occurs in women after menopause. Osteoporosis is usually combination of hormonal changes, inadequate intake of calcium and vitamin D deficiency.

Paget's disease

Paget's disease is associated with increased bone degradation and chaotic formation. Bones are painful; they easily deform, thicken and break more easily.

Primary bone cancers

This group includes malignant tumors arising from bone and surrounding connective tissue including so-called Ewing's sarcoma. Pathologic fractures occur in places of tumor growth and in areas affected by their metastases. It should be noted that primary malignant bone tumors and their metastases are relatively rare; bones are more often affected by metastases of other tumors (see below).


Bone metastatic process is associated with unpleasant bone pain (often in lumbar area) and pathologic fractures. Bone metastases are formed by many tumors, especially breast cancer, prostate cancer and lung cancer.

Benign bone deposits

Bone strength may be reduced by various lesions that are not of malignant origin. This includes benign tumors of bone and bone cysts.

Multiple myeloma

Multiple myeloma is a cancer developing from white blood cells. It affects flat and short bones such as skull bones and ribs. In addition to bone pain, fractures occur very easily. More detailed information can be found in relevant article.


Increased parathyroid function is associated with higher production of parathyroid hormone (PTH) that is responsible for bones decalcification.

Diagnostic approach

Diagnosis is based on medical history and physical examination. X-ray of affected bones is usually done (X-ray of ribs and skull in myeloma suspicion). Decalcification of bones can be confirmed from blood tests. Osteoporosis is diagnosed by densitometry. Densitometer is a special X-ray for bone density evaluation. Skeletal metastases can be found by bone scintigraphy. Further diagnostic approach and possible treatment is conducted according to results of previously mentioned examinations.

Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources