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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 4, 465-470.
doi: 10.1302/0301-620X.87B4.14954  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Radionuclide imaging of the painful hip arthroplasty

POSITRON-EMISSION TOMOGRAPHY VERSUS TRIPLE-PHASE BONE SCANNING

P. Reinartz, MD, Senior Physician1; T. Mumme, MD, Research Fellow2; B. Hermanns, MD, Senior Physician3; U. Cremerius, MD, Senior Physician1; D. C. Wirtz, MD, Senior Physician2; W. M. Schaefer, MD, Research Fellow1; F.-U. Niethard, MD, Professor of Orthopaedic Surgery2; and U. Buell, MD, Professor of Nuclear Medicine1

1 Department of Nuclear Medicine
2 Department of Orthopaedic Surgery
3 Institute of Pathology, University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.

Correspondence should be sent to Dr. P. Reinartz; e-mail: preinartz{at}compuserve.com

Two major complications of hip replacement are loosening and infection. Reliable differentiation between these pathological processes is difficult since both may be accompanied by similar symptoms. Our aim was to assess the diagnostic ability of triple-phase bone scanning (TPBS) and positron-emission tomography (PET) to detect and differentiate these complications in patients with a hip arthroplasty. Both TPBS and PET were performed in 63 patients (92 prostheses). The radiotracer for PET imaging was 18F-fluorodeoxyglucose (FDG). Image interpretation was performed according to qualitative and quantitative criteria although the final diagnosis was based upon either surgical findings or clinical follow-up.

The sensitivity, specificity and accuracy of PET was 0.94, 0.95 and 0.95 respectively, compared with 0.68, 0.76 and 0.74 for TPBS. We found that an image interpretation based exclusively upon quantitative criteria was inappropriate because of its low selectivity. The histological examination indicated that increased periprosthetic uptake of FDG in patients with aseptic loosening was caused by wear-induced polyethylene particles and the subsequent growth of aggressive granulomatous tissue.




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S. Nagoya, M. Kaya, M. Sasaki, K. Tateda, and T. Yamashita
Diagnosis of peri-prosthetic infection at the hip using triple-phase bone scintigraphy
J Bone Joint Surg Br, February 1, 2008; 90-B(2): 140 - 144.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General