Current clinical practice lacks an accurate predictor for the pathological fracture risk in metastatic bone disease, but biomechanical tools are under development to improve these predictions. In this paper we explain the limitations of currently used clinical guidelines and provide an overview of more objective and quantitative approaches that have been proposed for fracture risk assessment in metastatic bone disease. Currently, such mechanical models are as sensitive and specific as clinical guidelines, but there are a number of opportunities to further improve their predictive capacity. Hence, they are a promising tool to decrease the numbers of over- and undertreated patients.
Derikx, L. C., Verdonschot, N. J. J., & Tanck, E. (2015). Towards clinical application of biomechanical tools for the prediction of fracture risk in metastatic bone disease. Journal of biomechanics, 48(5), 761-766. https://doi.org/10.1016/j.jbiomech.2014.12.017