Pathologic / Fragility Fractures - Differential Diagnosis Algorithm 

Tumours

 - See Bone Lesions Scheme

Paget's Disease

 - Skull/spine/Pelvis

 - Positive Alkaline Phosphatase

Renal Osteodystrophy

 - Secondary to Chronic Renal Failure

Osteomalacia / Ricketts

 - Diffuse Pain/Proximal Muscle Weakness

 • Vitamin D Deficiency

 • Mineralization Defect

 • Phosphate Deficiency

Primary Osteoporosis

 • Post-Menopausal

 • Elderly

Secondary Osteoporosis 

 • Gastrointestinal Disease

 • Bone Marrow Disorder

 • Endocrinopathy

 • Malignancy

 • Drugs (e.g. corticosteroids)

 • Rheumatoid Disease

 • Renal Disease

 • Poor Nutrition

 • Immobilization



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