Fig. 3
From: Internal validation of modified Mirels’ scoring system for pathologic femur fractures
Patient example with fracture. Legend: A female patient presented with metastatic breast cancer involving bilateral proximal femurs as well as lesions in the left femoral diaphysis. Mirels score for the left femoral lesions was rated as 3 for pain, 2 for size, 1 for lesional characteristics. The femur had lesions in the diaphysis and intertrochanteric region resulting in a location score of 3 for Original Mirels and Modified Mirels scoring (A). Overall Original and Modified Mirels score of 9 was calculated. The patient had stable pain levels and was not interested in surgery; the decision was made to observe her. The patient then had a ground level fall 2 months later and sustained a pathologic fracture through the diaphyseal lesion requiring cephalomedullary fixation (B)