Pathologic Fracture (Humerus)

Pathologic fractures result from an underlying abnormality of the bone, usually either from a primary bone tumor or from metastatic disease. However, pathologic fractures may result from metabolic conditions as well. A pathologic fracture results when normal stress is placed onto abnormal bone.
A Lateral radiograph of the humerus. There is a comminuted fracture of the shaft. Examining the image closely shows a permeative destructive process as well. This patient had lung cancer with other osseous metastases. This is a pathologic fracture.

B AP and lateral radiographs of the humerus. One year prior, the lytic lesion is not apparent.

C AP radiograph of the humerus. A similar fracture of the humerus is apparent. Notice that there is no destructive process. This patient was in an automobile accident.

Links to online textbooks

Wheeless' Orthopedics: menu of pathologic fractures

References:

Michaeli DA, Inoue K, Hayes WC, Hipp JA: Density predicts the activity-dependent failure load of proximal femora with defects Skeletal Radiol. 1999 Feb;28(2):90-5. [See related articles]
Baur A, Stabler A, Bruning R, Bartl R, Krodel A, Reiser M, Deimling M: Diffusion-weighted MR imaging of bone marrow: differentiation of benign versus pathologic compression fractures Radiology. 1998 May;207(2):349-56. [See related articles]

A	Lateral radiograph of the humerus. There is a comminuted fracture of the shaft. Examining the image closely shows a permeative destructive process as well. This patient had lung cancer with other osseous metastases. This is a pathologic fracture.
B	AP and lateral radiographs of the humerus. One year prior, the lytic lesion is not apparent.
C	AP radiograph of the humerus. A similar fracture of the humerus is apparent. Notice that there is no destructive process. This patient was in an automobile accident.