Aims. The modern prevalence of primary tumours causing metastatic bone disease is ill-defined in the oncological literature. Therefore, the purpose of this study is to identify the prevalence of primary tumours in the setting of metastatic bone disease, as well as reported rates of
Opinion remains divided as to whether the development
of
Aims. The aim of this paper was to investigate the prognostic factors for local recurrence in patients with
Aims. The aim of this study was to validate the Mirels score in predicting
pathological fractures in metastatic disease of the lower limb. Patients and Methods. A total of 62 patients with confirmed metastatic disease met
the inclusion criteria. Of the 62 patients, 32 were female and 30
were male. The mean age of patients was 65 years (35 to 89). The
primary malignancy originated from the breast in 27 (44%) patients,
prostate in 15 (24%) patients, kidney in seven (11%), and lung in
four (6%) of patients. One patient (2%) had metastatic carcinoma
from the lacrimal gland, two patients (3%) had multiple myeloma,
one patient (2%) had lymphoma of bone, and five patients (8%) had
metastatic carcinoma of unknown primary. Plain radiographs at the
time of initial presentation were scored using Mirels system by
the four authors. The radiographic components of the score (anatomical
site, size, and radiographic appearance) were scored two weeks apart.
Inter- and intraobserver reliability were calculated with Fleiss’
kappa test. Bland-Altman plots were created to compare the variances
of the individual components of the score and the total Mirels score. Results. Kappa values for the interobserver variability of the components
of the Mirels score were k = 0.554 (95% CI 0.483 to 0.626) for site,
k = 0.342 (95% CI 0.285 to 0.400) for size, k = 0.443 (95% CI 0.387
to 0.499) for radiographic appearance, and k = 0.294 (95% CI 0.258
to 0.331)for the total score. Kappa values for the intra-observer
reliability were k = 0.608 (95% CI 0.506 to 0.710) for site, k = 0.579
(95% CI 0.487 to 0.670) for size, k = 0.614 (95% CI 0.522 to 0.703)
for radiographic appearance, and k = 0.323 (95% CI 0.266 to 0.379)
for total score. Conclusion. Our study showed fair to moderate agreement between authors when
using the Mirels score, and moderate to substantial agreement when
authors rescored radiographs. The Mirels score is subjective and
lacks reproducibility in predicting the risk of
Aims. The aim of this study was to assess the current trends in the estimation of survival and the preferred forms of treatment of
Introduction: Mirels scoring system is a recognised method of assessing the risk of fracture in metastatic bone disease (MBD) based on radiological and clinical risk factors. Although reproducible, there are overlaps in the outcome of the scores. Aim: The aim of this study is look at the association between the tumour volume and ratio, and the incidence of
Case Report: Metastatic deposits in the proximal femur commonly result in
We investigated whether the presence of a pathological
fracture increased the risk of local recurrence in patients with
a giant cell tumour (GCT) of bone. We also assessed if curettage
is still an appropriate form of treatment in the presence of a pathological
fracture. We conducted a comprehensive review and meta-analysis
of papers which reported outcomes in patients with a GCT with and
without a
Aim of presentation: We present a case of patellar metastasis from lung carcinoma resulting in
We reviewed the treatment and clinical outcome of 32 consecutive patients with Ewing’s sarcoma who presented with or developed
We reviewed the treatment and clinical outcome of 32 consecutive patients with Ewing’s sarcoma who presented with or developed
Introduction: Metastases in multiple myeloma are typically lytic and when non-union occurs it is usually atrophic. Methods: We report a lady of 67 years who was diagnosed with myeloma 9 years previously. She presented with a sudden onset of pain in her right forearm. Plain radiographs demonstrated a lytic lesion typical of multiple myeloma with an undisplaced
Large benign lytic lesions of the proximal femur present a significant risk of
Bone loss secondary to primary or metastatic lesions of the proximal humerus remains a challenging surgical problem. Options include preservation of the joint with stabilisation using internal fixation or resection of the tumour with prosthetic replacement. Resection of the proximal humerus often includes the greater tuberosity and adjacent diaphysis, which may result in poor function secondary to loss of the rotator cuff and/or deltoid function. Preservation of the joint with internal fixation may reduce the time in hospital and peri-operative morbidity compared with joint replacement, and result in a better functional outcome. We included 32 patients with
Introduction: Estimates suggest that 50% of new cases of invasive cancer diagnosed each year will eventually metastasise to bone. The proximal end of the femur is the most common site of long bone involvement by metastatic disease. Accepted principles for the treatment of metastatic disease of the proximal femur have been published. The results of 31 consecutive patients treated with a long intramedullary hip screw for metastatic disease of the proximal femur are reported. Patients and Methods: Retrospective case note review of all patients that had a long intramedullary hip screw for metastatic disease affecting the proximal femur over a four-year period 1998–2002. Results: The case notes of 31 patients (33 femurs) were reviewed. There were 21 females and 12 males with a mean age of 71 years. 31 femurs were Zickel group Ia or Ib, the remaining 2 were impending
We report the case of an 82-year-old man with a
Introduction:
Eleven patients with metastases in the cervical spine had operations for severe pain due to a
Purpose: The purpose of this study was to determine factors predictive of tumour recurrence, or refracture, following curettage as treatment for