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Radiation-Induced Complications of Skeleton
B.J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Definitions

            • Spectrum of osseous abnormalities related to radiation
              • Acute nonneoplastic marrow abnormalities
                • Focal or diffuse, fluctuating over time
              • Chronic red marrow replacement with fatty marrow
              • Radiation osteonecrosis
              • Radiation-induced growth deformities
              • Radiation-induced osteochondroma
              • Radiation-induced sarcoma
              • Fragility fractures

          IMAGING

          • General Features

            • Radiographic Findings

              • MR Findings

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    • Gross Pathologic & Surgical Features

                      CLINICAL ISSUES

                      • Presentation

                        • Demographics

                          • Natural History & Prognosis

                            • Treatment

                              DIAGNOSTIC CHECKLIST

                              • Image Interpretation Pearls

                                Selected References

                                1. Oest ME et al: Long-term loss of osteoclasts and unopposed cortical mineral apposition following limited field irradiation. J Orthop Res. ePub, 2014
                                2. Zbojniewicz AM et al: Posttreatment imaging of pediatric musculoskeletal tumors. Radiographics. 34(3):724-40, 2014
                                3. Nagata S et al: Chondrosarcoma arising within a radiation-induced osteochondroma several years following childhood total body irradiation: case report. Skeletal Radiol. 42(8):1173-7, 2013
                                4. Pacheco R et al: Effects of radiation on bone. Curr Osteoporos Rep. 11(4):299-304, 2013
                                5. Rasband J et al: Radiologic case study. Chondroblastic osteosarcoma and osteochondromas after prior total body irradiation. Orthopedics. 36(11):820, 886-9, 2013
                                6. Hwang S et al: Local changes in bone marrow at MRI after treatment of extremity soft tissue sarcoma. Skeletal Radiol. 38(1):11-9, 2009
                                7. Taitz J et al: Osteochondroma after total body irradiation: an age-related complication. Pediatr Blood Cancer. 42(3):225-9, 2004
                                8. Forest M et al: Secondary osteosarcomas. In: Fletcher CDM et al eds. World Health Organization Classification of Tumours: Tumours of Soft Tissue and Bone. Lyon: IARC Press; 2002:277
                                9. Murphey MD et al: Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics. 20(5):1407-34, 2000
                                10. Mitchell MJ et al: Radiation-induced changes in bone. Radiographics. 18(5):1125-36; quiz 1242-3, 1998
                                11. Feigen M: Should cancer survivors fear radiation-induced sarcomas? Sarcoma. 1(1):5-15, 1997
                                12. Mahboubi S et al: Malignant degeneration of radiation-induced osteochondroma. Skeletal Radiol. 26(3):195-8, 1997
                                13. Langenskiƶld A et al: Initiation of chondrodysplasia by localized roentgen ray injury: an experimental study of bone growth. Acta Chir Scand. 99:353-373, 1950
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Top Differential Diagnoses

                                      • Diagnostic Checklist

                                        TERMINOLOGY

                                        • Definitions

                                          • Spectrum of osseous abnormalities related to radiation
                                            • Acute nonneoplastic marrow abnormalities
                                              • Focal or diffuse, fluctuating over time
                                            • Chronic red marrow replacement with fatty marrow
                                            • Radiation osteonecrosis
                                            • Radiation-induced growth deformities
                                            • Radiation-induced osteochondroma
                                            • Radiation-induced sarcoma
                                            • Fragility fractures

                                        IMAGING

                                        • General Features

                                          • Radiographic Findings

                                            • MR Findings

                                              DIFFERENTIAL DIAGNOSIS

                                                PATHOLOGY

                                                • General Features

                                                  • Gross Pathologic & Surgical Features

                                                    CLINICAL ISSUES

                                                    • Presentation

                                                      • Demographics

                                                        • Natural History & Prognosis

                                                          • Treatment

                                                            DIAGNOSTIC CHECKLIST

                                                            • Image Interpretation Pearls

                                                              Selected References

                                                              1. Oest ME et al: Long-term loss of osteoclasts and unopposed cortical mineral apposition following limited field irradiation. J Orthop Res. ePub, 2014
                                                              2. Zbojniewicz AM et al: Posttreatment imaging of pediatric musculoskeletal tumors. Radiographics. 34(3):724-40, 2014
                                                              3. Nagata S et al: Chondrosarcoma arising within a radiation-induced osteochondroma several years following childhood total body irradiation: case report. Skeletal Radiol. 42(8):1173-7, 2013
                                                              4. Pacheco R et al: Effects of radiation on bone. Curr Osteoporos Rep. 11(4):299-304, 2013
                                                              5. Rasband J et al: Radiologic case study. Chondroblastic osteosarcoma and osteochondromas after prior total body irradiation. Orthopedics. 36(11):820, 886-9, 2013
                                                              6. Hwang S et al: Local changes in bone marrow at MRI after treatment of extremity soft tissue sarcoma. Skeletal Radiol. 38(1):11-9, 2009
                                                              7. Taitz J et al: Osteochondroma after total body irradiation: an age-related complication. Pediatr Blood Cancer. 42(3):225-9, 2004
                                                              8. Forest M et al: Secondary osteosarcomas. In: Fletcher CDM et al eds. World Health Organization Classification of Tumours: Tumours of Soft Tissue and Bone. Lyon: IARC Press; 2002:277
                                                              9. Murphey MD et al: Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics. 20(5):1407-34, 2000
                                                              10. Mitchell MJ et al: Radiation-induced changes in bone. Radiographics. 18(5):1125-36; quiz 1242-3, 1998
                                                              11. Feigen M: Should cancer survivors fear radiation-induced sarcomas? Sarcoma. 1(1):5-15, 1997
                                                              12. Mahboubi S et al: Malignant degeneration of radiation-induced osteochondroma. Skeletal Radiol. 26(3):195-8, 1997
                                                              13. Langenskiƶld A et al: Initiation of chondrodysplasia by localized roentgen ray injury: an experimental study of bone growth. Acta Chir Scand. 99:353-373, 1950