Irradiation Necrosis of the Head of the Femur

MacDougall, Julie

doi:10.1001/archsurg.1950.01250020329015

Cited by 13 publications

(3 citation statements)

References 9 publications

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“…As dead bone is being revascularized and remodeled, the forces involved in weight-bearing contribute to collapse and fracture [ 9 , 13 ]. Indeed, weight-bearing has been described as a repetitive traumatic insult, capable of exacerbating an evolving picture of AVN [ 2 ], and even repeated slight injury to tissues with a diminished capacity for recovery have been blamed for instigating AVN [ 5 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Other case reports have described AVN after a dose as low as 1540 rads in the absence of systemic therapy [ 7 , 26 ], and therefore it is likely that the total dose is not the predominant factor [ 2 ]. In the absence of being able to conclude there is a dose ceiling below which AVN does not occur, as suggested by the present case and literature review, it is therefore likely that radiation-induced AVN is a stochastic effect.…”

Section: Discussionmentioning

confidence: 99%

“…AVN most commonly affects bones with a single terminal blood supply and limited collateral circulation, such as the femoral head [ 2 ]. The postulated mechanisms of interruption of blood flow include: vascular occlusion, altered lipid metabolism, and intravascular coagulation [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Avascular Necrosis of the Femoral Head After Palliative Radiotherapy in Metastatic Prostate Cancer: Absence of a Dose Threshold?

Daoud

Magnus

Huang

et al. 2016

Cureus

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Avascular necrosis (AVN) is the final common pathway resulting from insufficient blood supply to bone, commonly the femoral head. There are many postulated etiologies of non-traumatic AVN, including corticosteroids, bisphosphonates, and radiotherapy (RT). However, it is unclear whether there is a dose threshold for the development of RT-induced AVN. In this case report, we describe a patient with prostate cancer metastatic to bone diagnosed with AVN after receiving single-fraction palliative RT to the left femoral head. Potential contributing factors are discussed, along with a review of other reported cases. At present, the RT dose threshold below which there is no risk for AVN is unknown, and therefore detrimental impact from the RT cannot be excluded. Given the possibility that RT-induced AVN is a stochastic effect, it is important to be aware of the possibility of this diagnosis in any patient with a painful hip who has received RT to the femoral head.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%