Case report 361: Radium intoxication with radium-induced osteonecrosis

In summary, a male patient was treated with radium chloride for arthritis involving both knees at a time when he had gonococcal urethritis. He was then 20 years of age and was followed until his death 40 years later at the age of 60 years. During that interval this individual, who possessed one of the largest burdens of radium ever recorded in man, developed spontaneous fractures of both femori and one humerus, symptomatic osteonecrosis of both femoral heads, dramatic progressive radiological findings of bone, and finally, a carcinoma of the maxillary sinus which proved to be the cause of his death. Tissue was obtained from both cortical and cancellous bone at four different times during the patient's life and again at post-mortem. Progressive ischemia with abnormal calcification and then necrosis of both bone and bone marrow were demonstrated in the skeletal tissues. The pathological chances are correlated superbly with the roentgenograms in this report. (orig.)