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Pathologic fractures occur in bones weakened by disease, such as osteoporosis, t

Pathologic fractures occur in bones weakened by disease, such as osteoporosis, tumors, or infections. The pain from pathologic fractures tends to be more severe and persistent compared to other types because the underlying disease continuously affects bone integrity. These fractures often present with minimal trauma or even during normal activities, leading to sudden, sharp pain at the fracture site. The pain is usually constant and exacerbated by weight-bearing or movement. In cases where malignancy is involved, the pain might also be associated with systemic symptoms like weight loss and night sweats.

Stress fractures are tiny cracks in bones caused by repetitive force or overuse, often seen in athletes or military recruits. The pain from stress fractures typically starts as a dull ache that progressively worsens with continued activity. Unlike pathologic fractures, stress fractures might initially be asymptomatic but become painful over time, especially with weight-bearing activities. The pain usually subsides with rest but can return quickly upon resuming activities. Swelling and tenderness are common at the site of the fracture, and the pain tends to be localized (Mayo Clinic, 2021).

Transchondral fractures involve the cartilage and underlying bone, often occurring in joints like the ankle or knee. These fractures result from acute trauma or repetitive stress that causes a shearing force across the cartilage. The pain from transchondral fractures is usually sharp and immediately following the injury. Swelling and joint effusion (fluid accumulation) often accompany the pain, and joint movement can be severely limited due to both pain and mechanical obstruction caused by loose cartilage fragments. Over time, if untreated, these fractures can lead to chronic pain and joint instability due to cartilage damage. Treatment typically involves addressing any underlying joint pathology, such as osteochondritis dissecans, and may require surgical intervention to restore joint function and alleviate pain (Van Bergen et al., 2021).

References

Mayo Clinic. (2021). Stress fractures: Symptoms & causes. https://www.mayoclinic.org/diseases-conditions/stress-fractures/symptoms-causes/syc-20354057

Johansen, A., Mansoubi, M., & Jordan, K. P. (2020). Pathological Fractures. In StatPearls. StatPearls Publishing.

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