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Osteoradionecrosis is a rare complication of radiation therapy. The pelvic and facial bones are those most likely to be affected when radiotherapy is used to manage gynaecological or nasopharyngeal malignancies. We report a 78-year-old woman with osteoradionecrosis of the acetabulum in a total hip arthroplasty 4 years after radiotherapy for a carcinoma of the vagina. Osteolysis of the acetabulum with pelvic discontinuity was noted on radiographs, but the patient was asymptomatic.