Edited by Laura Lu and Nathan Thomas - 7/1/2021
CALCULATOR
If score 8 or more, recommend prophylactic fixation.
Site: Upper limb +1 ; Lower limb +2, Trochanteric +3
Size: <⅓ cortical involvement +1; ⅓ - ⅔ cortical involvement +2; >⅔ cortical involvement +3
Nature of lesion: Blastic +1; Mixed +2; Lytic +3
Pain: Mild +1; Moderate +2; Functional +3
Based off original paper
Mirels H. Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures. Clin Orthop Relat Res. 1989 Dec;(249):256-64. PMID: 2684463.