Radiation-induced insufficiency fracture of the femur 18 years after radiation therapy

Francis G. Celii, Nicholas M Beckmann

Research output: Contribution to journalArticle

Abstract

Advances in oncologic treatment have improved survival rates, allowing late effects of radiotherapy to become more prevalent. Our patient, an 82-year-old woman with a remote history of right thigh basal cell carcinoma treated with resection and radiation therapy 18 years prior, presented with severe right thigh pain and inability to bear weight as she had suffered a femur fracture after a fall from standing. Initial imaging was suspicious for pathologic fracture secondary to malignancy due to imaging findings and because radiation-induced fractures have rarely been reported beyond 44 months from treatment. However, upon further imaging, evidence pointed to radiation-induced osteonecrosis as the mechanism for her insufficiency fracture. This case highlights the permanent deleterious effects of radiation therapy on bone, and the prudence of considering radiation-induced osteonecrosis as a mechanism of injury in low-energy trauma even long after radiation therapy. In addition, the case serves to review the natural history of irradiated bone injury and pertinent imaging findings.

LanguageEnglish
Pages179-183
Number of pages5
JournalRadiology Case Reports
Volume14
Issue number2
DOIs
StatePublished - Feb 1 2019

Fingerprint

Stress Fractures
Osteonecrosis
Femur
Radiotherapy
Radiation
Bone and Bones
Thigh
Wounds and Injuries
Spontaneous Fractures
Basal Cell Carcinoma
Natural History
Survival Rate
Weights and Measures
Pain
Therapeutics
Neoplasms

Keywords

  • Bone
  • Femur
  • Fracture
  • Insufficiency
  • Musculoskeletal
  • Osteonecrosis
  • Radiation-induced
  • Radiotherapy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Radiation-induced insufficiency fracture of the femur 18 years after radiation therapy. / Celii, Francis G.; Beckmann, Nicholas M.

In: Radiology Case Reports, Vol. 14, No. 2, 01.02.2019, p. 179-183.

Research output: Contribution to journalArticle

Celii, Francis G. ; Beckmann, Nicholas M. / Radiation-induced insufficiency fracture of the femur 18 years after radiation therapy. In: Radiology Case Reports. 2019 ; Vol. 14, No. 2. pp. 179-183.
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