Pathological fracture


  • A 54 years old lady
  • Presented with painful swelling of right forearm after a trivial fall
  • History of right breast lump for 2 years
  • Recently had FNAC done in another hospital
  • Defaulted follow up, not sure of FNAC result

Radiographic findings:

  • There is transverse fracture of the proximal third of right radial shaft (white arrow).
  • Anterior angulation is seen of distal fracture fragment.
  • The bone adjacent to fracture site showed permeative lytic changes. This lytic change has wide zone of transition with cortical thinning.
  • Another area of lytic change is seen at the radial tuberosity (yellow arrow).
  • No periosteal reaction.
  • No obvious soft tissue swelling.

Radiological diagnosis: Pathological fracture of right radius


  • Pathological fracture is a fracture that occurs through an abnormal bone.
  • Most frequently through a metastatic lesion or multiple myeloma.
  • Fracture line extend through the destructive bone lesion
  • Usually tranverse in direction
  • Frequently associated with soft tissue swelling
  • The most common locations are subtrochanteric femur, humeral head and vertebral body.

Progress of patient:

  • CT scan thorax, abdomen and pelvis done
CT scan thorax in axial plane soft tissue and bone windows

CT scan findings:

  • Advanced lesion involving the right breast (white arrow) with enlarged right axillary nodes (yellow arrow)
  • Destructive ytic lesion is also seen involving the left scapula (red arrow)


Author: radhianahassan