link
Bookmarks
Radiation-Induced Complications of Skeleton
Behrang Amini, MD, PhD; B. J. Manaster, MD, PhD, FACR
To access 4,300 diagnoses written by the world's leading experts in radiology.Try it free - 15 days
0
17
24
4

KEY FACTS

  • Terminology

    • Imaging

      TERMINOLOGY

      • Definitions

        • Spectrum of bone abnormalities related to radiation therapy (RT)
          • Radiation osteitis: potentially transient inflammatory reaction with bone marrow edema pattern and no evidence of necrosis
            • Variable progression to radiation osteonecrosis
          • Radiation osteonecrosis (ON): long-lasting marrow damage
          • RT-associated growth deformities
          • RT-associated osteochondroma
          • RT-associated sarcoma
          • RT-associated fragility fractures

      IMAGING

      • General Features

        • Radiographic Findings

          • MR Findings

            • Nuclear Medicine Findings

              DIFFERENTIAL DIAGNOSIS

                PATHOLOGY

                • General Features

                  CLINICAL ISSUES

                  • Presentation

                    • Demographics

                      • Natural History & Prognosis

                        • Treatment

                          DIAGNOSTIC CHECKLIST

                          • Image Interpretation Pearls

                            Selected References

                            1. Jackson TJ et al: Musculoskeletal complications following total body irradiation in hematopoietic stem cell transplant patients. Pediatr Blood Cancer. 65(4), 2018
                            2. Meixel AJ et al: From radiation osteitis to osteoradionecrosis: incidence and MR morphology of radiation-induced sacral pathologies following pelvic radiotherapy. Eur Radiol. 28(8):3550-9, 2018
                            3. Amini B et al: Osseous pseudoprogression in vertebral bodies treated with stereotactic radiosurgery: a secondary analysis of prospective phase I/II clinical trials. AJNR Am J Neuroradiol. 37(2):387-92, 2016
                            4. Oest ME et al: Long-term loss of osteoclasts and unopposed cortical mineral apposition following limited field irradiation. J Orthop Res. 33(3):334-42, 2015
                            5. Zbojniewicz AM et al: Posttreatment imaging of pediatric musculoskeletal tumors. Radiographics. 34(3):724-40, 2014
                            6. 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
                            7. Pacheco R et al: Effects of radiation on bone. Curr Osteoporos Rep. 11(4):299-304, 2013
                            8. Rasband J et al: Radiologic case study. Chondroblastic osteosarcoma and osteochondromas after prior total body irradiation. Orthopedics. 36(11):820, 886-9, 2013
                            9. 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
                            10. Taitz J et al: Osteochondroma after total body irradiation: an age-related complication. Pediatr Blood Cancer. 42(3):225-9, 2004
                            11. Forest M et al: Secondary osteosarcomas. In Fletcher CDM et al: World Health Organization Classification of Tumours: Tumours of Soft Tissue and Bone. IARC Press. 277, 2002
                            12. Murphey MD et al: Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics. 20(5):1407-34, 2000
                            13. Yoshioka H et al: MR imaging of radiation osteitis in the sacroiliac joints. Magn Reson Imaging. 18(2):125-8, 2000
                            14. Mitchell MJ et al: Radiation-induced changes in bone. Radiographics. 18(5):1125-36; quiz 1242-3, 1998
                            15. Feigen M: Should cancer survivors fear radiation-induced sarcomas? Sarcoma. 1(1):5-15, 1997
                            16. Mahboubi S et al: Malignant degeneration of radiation-induced osteochondroma. Skeletal Radiol. 26(3):195-8, 1997
                            17. Bragg DG et al: The clinical and radiographic aspects of radiation osteitis. Radiology. 97(1):103-11, 1970
                            18. Langenskiƶld A et al: Initiation of chondrodysplasia by localized roentgen ray injury: an experimental study of bone growth. Acta Chir Scand. 99:353-73, 1950
                            Related Anatomy
                            Loading...
                            Related Differential Diagnoses
                            Loading...
                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                TERMINOLOGY

                                • Definitions

                                  • Spectrum of bone abnormalities related to radiation therapy (RT)
                                    • Radiation osteitis: potentially transient inflammatory reaction with bone marrow edema pattern and no evidence of necrosis
                                      • Variable progression to radiation osteonecrosis
                                    • Radiation osteonecrosis (ON): long-lasting marrow damage
                                    • RT-associated growth deformities
                                    • RT-associated osteochondroma
                                    • RT-associated sarcoma
                                    • RT-associated fragility fractures

                                IMAGING

                                • General Features

                                  • Radiographic Findings

                                    • MR Findings

                                      • Nuclear Medicine Findings

                                        DIFFERENTIAL DIAGNOSIS

                                          PATHOLOGY

                                          • General Features

                                            CLINICAL ISSUES

                                            • Presentation

                                              • Demographics

                                                • Natural History & Prognosis

                                                  • Treatment

                                                    DIAGNOSTIC CHECKLIST

                                                    • Image Interpretation Pearls

                                                      Selected References

                                                      1. Jackson TJ et al: Musculoskeletal complications following total body irradiation in hematopoietic stem cell transplant patients. Pediatr Blood Cancer. 65(4), 2018
                                                      2. Meixel AJ et al: From radiation osteitis to osteoradionecrosis: incidence and MR morphology of radiation-induced sacral pathologies following pelvic radiotherapy. Eur Radiol. 28(8):3550-9, 2018
                                                      3. Amini B et al: Osseous pseudoprogression in vertebral bodies treated with stereotactic radiosurgery: a secondary analysis of prospective phase I/II clinical trials. AJNR Am J Neuroradiol. 37(2):387-92, 2016
                                                      4. Oest ME et al: Long-term loss of osteoclasts and unopposed cortical mineral apposition following limited field irradiation. J Orthop Res. 33(3):334-42, 2015
                                                      5. Zbojniewicz AM et al: Posttreatment imaging of pediatric musculoskeletal tumors. Radiographics. 34(3):724-40, 2014
                                                      6. 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
                                                      7. Pacheco R et al: Effects of radiation on bone. Curr Osteoporos Rep. 11(4):299-304, 2013
                                                      8. Rasband J et al: Radiologic case study. Chondroblastic osteosarcoma and osteochondromas after prior total body irradiation. Orthopedics. 36(11):820, 886-9, 2013
                                                      9. 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
                                                      10. Taitz J et al: Osteochondroma after total body irradiation: an age-related complication. Pediatr Blood Cancer. 42(3):225-9, 2004
                                                      11. Forest M et al: Secondary osteosarcomas. In Fletcher CDM et al: World Health Organization Classification of Tumours: Tumours of Soft Tissue and Bone. IARC Press. 277, 2002
                                                      12. Murphey MD et al: Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics. 20(5):1407-34, 2000
                                                      13. Yoshioka H et al: MR imaging of radiation osteitis in the sacroiliac joints. Magn Reson Imaging. 18(2):125-8, 2000
                                                      14. Mitchell MJ et al: Radiation-induced changes in bone. Radiographics. 18(5):1125-36; quiz 1242-3, 1998
                                                      15. Feigen M: Should cancer survivors fear radiation-induced sarcomas? Sarcoma. 1(1):5-15, 1997
                                                      16. Mahboubi S et al: Malignant degeneration of radiation-induced osteochondroma. Skeletal Radiol. 26(3):195-8, 1997
                                                      17. Bragg DG et al: The clinical and radiographic aspects of radiation osteitis. Radiology. 97(1):103-11, 1970
                                                      18. Langenskiƶld A et al: Initiation of chondrodysplasia by localized roentgen ray injury: an experimental study of bone growth. Acta Chir Scand. 99:353-73, 1950