Mirels' score is a tool useful in the management of bone tumors, by identifying those patients who would benefit from prophylactic fixation if they have a high enough risk of pathological fracture.

Scoring

A score of 1 to 3 is given for four criteria and summed together. A score greater than 8 suggests prophylactic internal fixation prior to irradiation.

Criteria[1] Score
1 2 3
Site Upper limb Lower limb Peritrochanteric
Pain Mild Moderate Functional
Lesion Blastic Mixed Lytic
Size <⅓ ⅓-⅔ >⅔

References

  1. Mirels, Hilton (1989). "Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures". Clinical Orthopaedics and Related Research. 249 (249): 256–64. doi:10.1097/00003086-198912000-00027. PMID 2684463. Republished as: Mirels, Hilton (2003). "The Classic: Metastatic Disease in Long Bones a Proposed Scoring System for Diagnosing Impending Pathologic Fractures". Clinical Orthopaedics and Related Research. 415 (415 Suppl): S4–13. doi:10.1097/01.blo.0000093045.56370.dd. PMID 14600587. S2CID 43255503.

Further reading

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