SEMAR significantly improves the image quality of periarticular soft-tissue structures in patients with hip prostheses.

The ADCmin values obtained with manual ROI positioning offered the best diagnostic performance for tumor characterization. The semiautomatic method yielded similar specificity values. For solid masses, the ADCavg values were better correlated with tumor histology than the ADCmin values.

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We have developed a diagnostic tree based on the characteristics of each imaging technique and recommend its use. Computed topography was found to be the most versatile and cost-effective imaging solution and therefore a key tool for diagnosing the complications of hip replacement surgery.

Patients with hip pain after joint replacement are first assessed by analyzing the clinical presentation and conventional radiography findings. When this first step is inconclusive, various different imaging techniques can be used to identify the anomalies. Based on our experience, computed tomography (CT) is the cornerstone for diagnosing the main prosthesis-related complications. In this article, we describe the different CT techniques used for this kind of investigation and provide indications for each technique.