Brooke Renee Beckett MD, Presenter: Nothing to Disclose

1) To recognize the osseous and soft tissue complications of tumor treatment, specifically those caused by radiation, chemotherapy, and surgery. These include radiation osteitis, osteonecrosis, insufficiency fractures, secondary malignancy, myositis and myonecrosis, and muscle denervation changes.

Musculoskeletal complications of tumor treatment are relatively common, often symptomatic, and therefore, an important cause of morbidity in the posttreatment cancer patient. Radiation causes local marrow changes such as osteitis, osteonecrosis and osteopenia, predisposing to insufficiency fractures. It may also cause local muscle damage, most commonly myositis, but occasionally myonecrosis. A rare but especially dreaded complication of radiation is secondary bone or soft tissue sarcoma, which will also be described. Chemotherapy, particularly protocols that include high doses of steroids, predisposes to osteonecrosis. And finally, surgical resection of extremity tumors, either primary or metastatic, may lead to muscle denervation changes. The bones and soft tissues should be carefully reviewed on all surveillance imaging, be it radiographs, CT or MRI, to exclude the presence of these often treatable complications.

Beckett, B, Imaging Musculoskeletal Complications.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000600.html