Ta. Wignall et al., POST-RADIOTHERAPY OSTEOMYELITIS OF THE SYMPHYSIS PUBIS - COMPUTED TOMOGRAPHIC FEATURES, Clinical Radiology, 53(2), 1998, pp. 126-130
We report the clinical and computed tomography (CT) features of seven
patients with osteomyelitis of the symphysis pubis following radiother
apy for bladder (n = 4) or cervical (n = 3) carcinoma, The patients pr
esented with fistulae (n = 5), pain (n = 1) or small bowel obstruction
(n = 1) between 6 and 19 years after radiotherapy, The diagnosis was
confirmed by surgery with histology or bacteriology of the symphysis p
ubis and/or associated abscess in all patients, In addition to bone de
struction, other features identified on CT included abscesses, bowel l
oops adherent to the symphysis pubis and/or communicating with an absc
ess cavity, a soft tissue mass enveloping the residual bone, and fistu
lae, The combination of clinical and radiological features suggests os
teomyelitis and, for patients who have had pelvic radiotherapy, this t
reatable condition should be included in the differential diagnosis of
solitary symphysis pubis destruction.