open access

Vol 16, No 5 (2011)
Case reports
Published online: 2011-09-01
Submitted: 2010-11-05
Get Citation

Radiotherapy induced hip joint avascular necrosis—Two cases report

Łukasz Michalecki, Dorota Gabryś, Roland Kulik, Jerzy Wydmański, Krystyna Trela
DOI: 10.1016/j.rpor.2011.04.004
·
Rep Pract Oncol Radiother 2011;16(5):198-201.

open access

Vol 16, No 5 (2011)
Case reports
Published online: 2011-09-01
Submitted: 2010-11-05

Abstract

Background

Avascular necrosis (AVN) refers to the death of osteocytes and osteoblasts. Sites such as the femoral head, the head of the humerus and the mandibula with restricted access to local blood supply are particularly vulnerable to osteonecrosis.

A combination of several factors is responsible for ischaemia and is associated with AVN: corticosteroids, alcohol abuse, Cushing's syndrome, SLE, systemic vasculitis, RA, scleroderma, haemoglobinopathies, radiotherapy. Management is based on proper diagnosis and treatment – conservative, pharmacological or surgical.

Radiotherapy has become an integral part of the therapeutic programme of cancer patients. However, early and late after-effects of irradiation still constitute a significant issue in clinical practice.

Aim

The aim of this report is to present two cases of acetabular protrusion and femoral head deformities after a therapeutic pelvic irradiation and draw physicians’ attention to that clinical problem which continues to be underestimated.

Materials and methods

This report documents two cases of acetabular protrusion and femoral head deformities after a therapeutic pelvic radiation.

Results

Avascular necrosis (AVN) constitutes a severe and challenging long-term complication in radiation oncology.

Conclusion

It is necessary to take into account bone structures among organ at risk (OAR) involved in irradiation fields. The detailed analysis of the dose distribution and the use of collimators allow to decrease the total dose to OAR.

An adequate management, early diagnosis and prompt, proper treatment may protect patients from long-term morbidities.

Abstract

Background

Avascular necrosis (AVN) refers to the death of osteocytes and osteoblasts. Sites such as the femoral head, the head of the humerus and the mandibula with restricted access to local blood supply are particularly vulnerable to osteonecrosis.

A combination of several factors is responsible for ischaemia and is associated with AVN: corticosteroids, alcohol abuse, Cushing's syndrome, SLE, systemic vasculitis, RA, scleroderma, haemoglobinopathies, radiotherapy. Management is based on proper diagnosis and treatment – conservative, pharmacological or surgical.

Radiotherapy has become an integral part of the therapeutic programme of cancer patients. However, early and late after-effects of irradiation still constitute a significant issue in clinical practice.

Aim

The aim of this report is to present two cases of acetabular protrusion and femoral head deformities after a therapeutic pelvic irradiation and draw physicians’ attention to that clinical problem which continues to be underestimated.

Materials and methods

This report documents two cases of acetabular protrusion and femoral head deformities after a therapeutic pelvic radiation.

Results

Avascular necrosis (AVN) constitutes a severe and challenging long-term complication in radiation oncology.

Conclusion

It is necessary to take into account bone structures among organ at risk (OAR) involved in irradiation fields. The detailed analysis of the dose distribution and the use of collimators allow to decrease the total dose to OAR.

An adequate management, early diagnosis and prompt, proper treatment may protect patients from long-term morbidities.

Get Citation

Keywords

Osteoradionecrosis; Aseptic necrosis; Avascular necrosis; Radiotherapy

About this article
Title

Radiotherapy induced hip joint avascular necrosis—Two cases report

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 16, No 5 (2011)

Pages

198-201

Published online

2011-09-01

DOI

10.1016/j.rpor.2011.04.004

Bibliographic record

Rep Pract Oncol Radiother 2011;16(5):198-201.

Keywords

Osteoradionecrosis
Aseptic necrosis
Avascular necrosis
Radiotherapy

Authors

Łukasz Michalecki
Dorota Gabryś
Roland Kulik
Jerzy Wydmański
Krystyna Trela

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