The Mirels scoring system is used to assess the risk of pathological fracture in long bone metastases. Which of the following is NOT one of the four parameters scored?

• A Site of the lesion
• B Size of the lesion relative to the bone diameter
• C Nature of the lesion (lytic, mixed, or blastic)
• D Histological grade of the primary tumour ✓

Explanation

Mirels scores four radiological and clinical parameters: site (upper limb versus lower limb), size (less than one third, one to two thirds, more than two thirds of the bone diameter), nature of the lesion, and degree of pain. Histological grade of the primary tumour is deliberately excluded because many patients with skeletal metastasis never undergo biopsy, keeping the score applicable at first presentation. Each parameter scores 1 to 3, giving a maximum of 12.

Reference: Campbell's Operative Orthopaedics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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