|Location||Upper extremity||Lower extremity||Intertrochanteric|
|Sizea||< 1/3||1/3 - 2/3||>2/3|
a Size is determined as a fraction of the cortical thickness.
b Functional pain is defined as severe pain or pain aggravated by limb function.
|≥9||33%-100%||Prophylactic fixation is recommended|
|=8||15%||Clinical judgment should be used|
|≤7||<4%||Observation and radiation therapy can be used|
As an example, the lytic, intertrochanteric lesion shown above takes up >2/3 of the cortical thickness, getting an overall score of 9 in the absence of any clinical information about the degree of pain.