Skeletal complications of radiation therapy

Radiation therapy is an important modality in the treatment of a wide variety of neoplasms. Skeletal complications of radiation therapy include alterations in bone growth, radiation osteitis with secondary stress fractures, and radiation-induced sarcoma. Routine follow-up of patients who are asymptomatic may show radiation changes that must be differentiated from recurrent disease. In symptomatic patients who are examined for metastatic disease, imaging findings may suggest stress fractures related to prior radiation therapy or, rarely, radiation-induced tumors. Correlation of the clinical presentation, radiation ports, and radiologic findings will often help in the differential diagnosis in these patients.