Radiation osteitis of the clavicle following radiotherapy and radical neck dissection of head and neck cancer.

The bone alterations in the region of the clavicle (3 cases) are similar to those we have observed and described elsewhere in the skeleton i.e., the mandible, maxillary and ethmoid bones. Rarefaction is the result of three different types of bone destruction: osteoclasia, a kind of osteocytic osteolysis only observed after irradiation and obviously related with infection, and a pure demineralization of the osseous tissue by contact with pus. Reconstruction processes, although unable to prevent spontaneous fracture, are also present and correspond to islets of chondroid tissue surrounded by lamellar bone. However, these recently deposited calcified tissues are already necrotic since most of their lacunae are empty.