A pathologic fracture is a bone fracture caused by weakness of the bone structure that leads to decrease mechanical resistance to normal mechanical loads. This process is most commonly due to osteoporosis, but may also be due to other pathologies such as cancer, infection (such as osteomyelitis), inherited bone disorders, or a bone cyst. Only a small number of conditions are commonly responsible for pathological fractures, including osteoporosis, osteomalacia, Pagets disease, Osteitis, osteogenesis imperfecta, benign bone tumours and cysts, secondary malignant bone tumours and primary malignant bone tumours. Fragility fracture is a type of pathologic fracture that occurs as a result of an injury that would be insufficient to cause fracture in a normal bone. There are three fracture sites said to be typical of fragility fractures: vertebral fractures, fractures of the neck of the femur, and Colles fracture of the wrist. This definition arises because a normal human being ought to be able to fall from standing height without breaking any bones, and a fracture, therefore, suggests weakness of the skeleton. Pathological fractures present as a chalkstick fracture in long bones, and appear as a transverse fractures nearly 90 degrees to the long axis of the bone. In a pathological compression fracture of a spinal vertebra fractures will commonly appear to collapse the entire body of vertebra. Cause
Pathologic fractures in children and adolescents can result from a diverse array of disorders namely; metabolic, endocrine, neoplastic, infectious, immunologic, and genetic skeletal dysplasias.
Hemoptysis is the coughing up of blood or blood-stained mucus from the bronchi, larynx, trachea, or lungs. In other words, it is the airway bleeding. This can occur with lung cancer, infections such as tuberculosis, bronchitis, or pneumonia, and certain cardiovascular conditions. Hemoptysis is considered massive at 300 mL (11 imp fl oz; 10 US fl oz). In such cases, there are always severe injuries. The primary danger comes from choking, rather than blood loss. Diagnosis
Past history, history of present illness, family historyhistory of tuberculosis, bronchiectasis, chronic bronchitis, mitral stenosis, etc. history of cigarette smoking, occupational diseases by exposure to silica dust, etc. Blood
duration, frequency, amount
Amounts of blood: large amounts of blood, or is there blood-streaked sputum
Probable source of bleeding: Is the blood coughed up, or vomited? Bloody sputum
color, characters: blood-streaked, fresh blood, frothy pink, bloody gelatinous. Accompanying symptoms
fever, chest pain, coughing, purulent sputum, mucocutaneous bleeding, jaundice. Imaging examination
chest X-ray, CT scan and 3D reconstruction images or CT virtual bronchoscopy, bronchial angiography. Laboratory tests
blood test: WBC
Sputum: cells and bacterial examinations, sputum culture
Bronchial fiber endoscopy

Differential diagnosis
The most common causes for hemoptysis in adults are chest infections such as bronchitis or pneumonia. In children, hemoptysis is commonly caused by the presence of a foreign body in the airway. Other common causes include lung cancers and tuberculosis. Less common causes include aspergilloma, bronchiectasis, coccidioidomycosis, pulmonary embolism, pneumonic plague, and cystic fibrosis. Rarer causes include hereditary hemorrhagic telangiectasia (HHT or Rendu-Osler-Weber syndrome), Goodpastures syndrome, and granulomatosis with polyangiitis.