Die pathologische Fraktur aus Sicht des Radiologen

Abstract

The conventional classifiaction of fractures does not always take the clinical and radiological findings sufficiently into consideration; a logical classification distinguishing generally between traumatic and pathological fractures is more suitable. Indications of a spontaneous fracture include pain prior to fracture, patient history, moth-eaten appearance of the fracture borders, corresponding to Lodwick grade II - III, and bone circumference reduction of >50%. In addition to X-rays, CT or MRI can be helpful in the diagnosis of spontaneous fractures by establishing prognostically important factors, i.e., the extent of vascular and osseous nerve destruction, as well as concomitant hematoma. Osteoporosis or osteomalacia are the most frequent causes of insufficiency fractures, which can be readily diagnosed on adequate X-ray images. Post-operatively, patients should be referred to a suitable institution for further diagnosis and therapy of the underlying disease. For this reason, doctor's letters should make explicit mention of the cause of insufficiency fracture. © 2008 Springer Medizin Verlag.