ostesarcoma proximal fibula, followup MRI

Dear Ocaders,
I have posted a question regarding this patient a year ago, regarding
fibular stump wich seemd modified in MRI signal and we all agreed that was
osteoradionecrosis.
Patient doctors from Vienna agreeed also, and recomended follow up
She came now for a follow up and fibula is fine, as expected
But I see a lot of changes in tibial site – the resection of the tumor
invoved some scraping of the tibial cortex and there alwys were some
modification due to radiotherapy most of them punctated – probably due to
marrow reconversion.
But now I see a fracture line inside all that modifications (there area of
BME is larger) and I ask your opinion:
– is it the same osteoradionecrosis with fracture due to bone fragility?
After almost 2 years from radiotherapy?
– should I worry and recommend biopsy?

Thank you!
sorin

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