Radiation osteitis: a problem of recognition.

Localized changes of radiation necrosis in 6 patients treated for Ewing sarcoma are described. Well-circumscribed lytic areas in the cortex of a previously irradiated long bone may be mistaken for tumor recurrence, especially if they are few in number and surrounded by relatively normal bone. The clarity of demarcation of these lesions, their progression, and the lack of a periosteal reaction are stressed.