Mirels H. Metastatic disease in long bones: A proposed scoring system for diagnosing impending pathologic fractures. 1989. Clin Orthop Relat Res. 2003;(415 Suppl):S4-13. 

Jawad MU, Scully SP. In brief: classifications in brief: Mirels' classification: metastatic disease in long bones and impending pathologic fracture. Clin Orthop Relat Res. 2010;468(10):2825-7.

Damron TA, Morgan H, Prakash D, Grant W, Aronowitz J, Heiner J. Critical evaluation of Mirels' rating system for impending pathologic fractures. Clin Orthop Relat Res. 2003;(415 Suppl):S201-7.

Dr. Hilton Mirels

//outputs
var calc_output = [];

//user inputs
var site = parseFloat(site);
var size = parseFloat(size);
var nature = parseFloat(nature);
var pain = parseFloat(pain);

//calculation
var u = site + size + nature + pain;

var msg, mini, risk;
if (u <= 7){
	msg = "Safe to irradiate with minimal risk of fracture";
	mini = "Ok to irradiate";
	risk = "0-4"
}
if (u == 8){
	msg = "Consider prophylactic fixation";
	mini = "Consider prophylactic fixation";
	risk = "15"
}
if (u >= 9){
	msg = "Prophylactic fixation indicated";
	mini = "Prophylactic fixation"
	risk = ">33"
}

//result user sees
calc_output.push({
name: 'mini',
value: u,
value_text: 'points',
message: mini
});

calc_output.push({
name: 'Output',
value: u,
value_text: 'points',
message: msg
});

calc_output.push({
name: 'risk',
value: risk,
value_text: '%',
message: 'Risk of fracture at 6 months post-irradiation'
});

Mirels’ Criteria for Prophylactic Fixation

site

size

nature

pain

<p>Predicts risk of pathologic fracture in patients with long bone metastasis.</p>

Mirels’ Criteria

Mirels’ Criteria for Prophylactic Fixation predicts risk of pathologic fracture in patients with long bone metastasis.

Fong Score

UISS for RCC

IMDC Model for mRCC

EB Medicine is the premier provider of evidence-based clinical content and CME resources for emergency medicine practitioners.

Listen to the VACO co-creators break down how to use VACO\, what it does\, and what it doesn’t.

Calc Function