TABLE I

Mirels Classification System for Fracture Risk*

Score
Variable123
SiteUpper extremityLower extremityPeritrochanteric
PainMildModerateFunctional
Lesion characteristicsBlasticMixedLytic
Size (relative to bone diameter)<1/31/3–2/3>2/3
  • * Modified, with permission, from: 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.