title: Impending fracture: A difficult diagnosis.
abstract: BACKGROUND
  The concept of impending fracture has been developed to help address this difficult skeletal-related problem. There is no consensus on the subject in the literature and a specific definition of impending fracture has not been outlined.
  
  
  CONCLUSIONS
  There is disagreement in the literature on the best criteria for the diagnosis of impending fracture. A method of discrimination for patients who need preventative treatment for a metastatic lesion has not yet been established.
  
  
  CONCLUSIONS
  Current score systems consider variables like size, location and treatment response and are easy to remember. However, these score systems have never been evaluated prospectively and rigorously, their sensitivity is low and they do not take into account potentially relevant factors that can influence patient prognosis. A consistent tool to evaluate impending fractures would be of great value to guide the treatment of metastatic bone disease.
authors.affiliation: Orthopedics Oncology, "Palazzo Baleani", Teaching Hospital Policlinico Umberto I, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Piccioli
authors.affiliation: Department of Orthopaedic Oncology, Agostino Gemelli Hospital, Catholic University of Rome, Largo Francesco Vito 1, Rome, Italy. Electronic address: msilviaspinelli@yahoo.it.
authors.forename: Maria Silvia
authors.initials: MS
authors.lastname: Spinelli
authors.affiliation: Department of Orthopaedic Oncology, Agostino Gemelli Hospital, Catholic University of Rome, Largo Francesco Vito 1, Rome, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Maccauro
mesh_terms: D001859:Bone Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D050723:Fractures, Bone / Q000517:prevention & control* / Q000601:surgery; D005598:Fractures, Spontaneous / Q000517:prevention & control* / Q000601:surgery; D006801:Humans; D017410:Practice Guidelines as Topic; D011379:Prognosis; D011788:Quality of Life
keywords: Bone; Impeding fracture; Metastasis