Fig. 4
From: Internal validation of modified Mirels’ scoring system for pathologic femur fractures
Patient Example without Fracture. Legend: A male patient with known disseminated multiple myeloma presented with a lytic lesion in the intertrochanteric region of the left proximal femur. The original Mirels score at the time of presentation was 9 (1 for pain, 2 for size, 3 for lesional characteristics, and 3 for location). Utilizing the Modified Mirels scoring system with a 2 score for location, the patient would be assigned a score of 8. Due to limited symptoms, he did not undergo prophylactic fixation. The patient remained free of fracture at latest available follow-up which, in this case, exceeded 2 years