POST-RADIOTHERAPY OSTEOMYELITIS OF THE SYMPHYSIS PUBIS - COMPUTED TOMOGRAPHIC FEATURES

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.