American Society for Bone and Mineral Research (ASBMR) Criteria for an Atypical Femoral Fracture

 

Major features:

(1) located distal to the lesser trochanter and proximal to the supracondylar flare

(2) transverse or short oblique fracture

(3) history of either no trauma or low-energy trauma (absence of high energy trauma)

(4) noncomminuted

(5) complete fracture: medial spike

(6) incomplete fracture: only in lateral column

 

Minor features:

(1) history of glucocorticoid or bisphosphonate therapy

(2) generalized cortical thickening

(3) prodromal thigh discomfort or pain

(4) bilateral

(5) localized periosteal reaction in the lateral cortex

(6) delayed healing

 

Features of a "typical" femoral fracture:

(1) history of high energy trauma

(2) comminuted

(3) spiral