The Mirels' criteria is a clinical scoring system used to predict the risk of pathologic fracture in patients with metastatic bone disease. This calculator is particularly useful in the management of patients with bone metastases, as it helps clinicians decide whether prophylactic fixation surgery is necessary to prevent a potential fracture. The Mirels' criteria takes into account four factors: the site of the lesion, the nature of the lesion (blastic, lytic, or mixed), the size of the lesion, and the presence of pain. Each factor is scored from 1 to 3, and a total score of 9 or more suggests a high risk of fracture, indicating the need for surgical intervention. There are no specific exclusion criteria for its use, but it should be noted that this scoring system is not applicable to patients without bone metastases.
Reference
Muhammad Umar Jawad, Sean P Scully. In Brief: Classifications in Brief: Mirels’ Classification: Metastatic Disease in Long Bones and Impending Pathologic Fracture. Clin Orthop Relat Res. 2010 Oct; 468(10): 2825–2827.
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