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Axial cortical destruction
< 30 mm
SF radiotherapy
Pain response
Pain worse or recurrent
Painful metastasis in the femur
Multidirectional X-rays
Follow-up
Profylactic surgery
MF radiotherapy
Condition acceptable
Postoperative MF radiotherapy
Axial cortical destruction
> 30 mm
Bad condition
Van der Linden, R&O 2003, JBJS 2004