Postradiation Sarcoma (Radiation-Induced Sarcoma) Differential Diagnoses

Updated: Jul 06, 2022
  • Author: Nagarjun Rao, MD, FRCPath; Chief Editor: Omohodion (Odion) Binitie, MD  more...
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Diagnostic Considerations

Differential diagnoses for bone pain in a patient with a history of irradiation include the following:

  • Metastatic bone disease
  • Radiation osteopathy
  • Nonneoplastic causes of bone pain, such as rotator cuff impingement syndrome, osteoarthritis, bursitis/ tendinitis, gout, and pseudogout

The pain in postradiation sarcoma (PRS; radiation-induced sarcoma [RIS]) is worse at night. The pain usually is not relieved with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs). Patients with arthritis also complain of worsening pain at night, but this usually is positional and only occasionally is severe enough to wake the patient. Arthritic pain also usually is exacerbated by activity and relieved by rest.

Differential Diagnoses