Low-Field-Strength MR Imaging of Failed Hip Arthroplasty: Association of Femoral Periprosthetic Signal Intensity with Radiographic, Surgical, and Pathologic Findings

Sugimoto, Hideharu; Hirose, Isao; Miyaoka, Etsuo; Fujita, Akifumi; Kinebuchi, Yuko; Yamamoto, Wakako; Itoh, Yu Ichi

doi:10.1148/radiol.2293021061

Cited by 30 publications

(13 citation statements)

References 19 publications

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“…MR imaging is a useful modality in the diagnosis of periprosthetic fractures, bone resorption and osteolysis, postoperative hematoma, disruption of the pseudocapsule, synovitis caused by polyethylene wear and adverse local tissue reactions, periprosthetic masses and neoplasms, bursitis, tendinopathy and tendon tears, and neurovascular compromise. MR imaging can also contribute information with regard to heterotopic ossification, infection, joint instability, and impingement (4)(5)(6)8,(13)(14)(15)(16)(17)(18).…”

Section: Imaging Technique Technical Considerationsmentioning

confidence: 99%

MR Imaging of Hip Arthroplasty Implants

et al. 2014

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Hip arthroplasty has become the standard treatment for end-stage hip disease, allowing pain relief and restoration of mobility in large numbers of patients; however, pain after hip arthroplasty occurs in as many as 40% of cases, and despite improved longevity, all implants eventually fail with time. Owing to the increasing numbers of hip arthroplasty procedures performed, the demographic factors, and the metal-on-metal arthroplasty systems with their associated risk for the development of adverse local tissue reactions to metal products, there is a growing demand for an accurate diagnosis of symptoms related to hip arthroplasty implants and for a way to monitor patients at risk. Magnetic resonance (MR) imaging has evolved into a powerful diagnostic tool for the evaluation of hip arthroplasty implants. Optimized conventional pulse sequences and metal artifact reduction techniques afford improved depiction of bone, implant-tissue interfaces, and periprosthetic soft tissue for the diagnosis of arthroplasty-related complications. Strategies for MR imaging of hip arthroplasty implants are presented, as well as the imaging appearances of common causes of painful and dysfunctional hip arthroplasty systems, including stress reactions and fractures; bone resorption and aseptic loosening; polyethylene wear-induced synovitis and osteolysis; adverse local tissue reactions to metal products; infection; heterotopic ossification; tendinopathy; neuropathy; and periprosthetic neoplasms. A checklist is provided for systematic evaluation of MR images of hip arthroplasty implants. MR imaging with optimized conventional pulse sequences and metal artifact reduction techniques is a comprehensive imaging modality for the evaluation of the hip after arthroplasty, contributing important information for diagnosis, prognosis, risk stratification, and surgical planning.

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Section: Imaging Technique Technical Considerationsmentioning

confidence: 99%

MR Imaging of Hip Arthroplasty Implants

et al. 2014

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“…Forty consecutive patients (mean age, 64.5 years; range, 36-92 years) with THA referred for MR imaging of M agnetic resonance (MR) imaging of total hip arthroplasty (THA) has been very limited for many years due to strong local susceptibility artifacts induced by the metal (1,2). More recently, MR imaging has increasingly been used in patients with THA, because unlike radiography, computed tomography (CT), scintigraphy, or positron emission tomography, it also enables visualization of the soft tissues surrounding the hip joint, yet artifacts still hamper MR image quality and image interpretation substantially (3,4). While the soft tissues that are located further from the metallic implant might be depicted well on MR images (5,6), it is particularly challenging to assess the bone and soft tissues directly adjacent to the hip prosthesis (7).…”

Section: Patientsmentioning

confidence: 99%

“…Fat suppression is a particular challenge in patients with metal implants. Conventional spectral fat suppression the detection of periprosthetic osteolysis and wear-induced synovitis (1,23), there are still distinct and detrimental artifacts in the bone and soft tissue adjacent to the metallic hardware that limit the use of MR imaging in patients with THA (4,23).…”

Section: Musculoskeletal Imaging: Reduction Of Metal Artifacts In Patmentioning

confidence: 99%

Reduction of Metal Artifacts in Patients with Total Hip Arthroplasty with Slice-encoding Metal Artifact Correction and View-Angle Tilting MR Imaging

Sutter¹,

Ulbrich²,

Jellúš³

et al. 2012

Radiology

143

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Section: Introductionmentioning

confidence: 99%

“…In recent years, there have been numerous studies examining its role in imaging THA [3,7,38,39,46,[50][51][52]. MRI is effective for detecting periarticular bony and soft-tissue abnormalities in patients with a postarthroplasty hip [3,39,46,52], as well as determining the source of enigmatic hip following THA [7]. Due to its direct multiplanar capabilities and superior soft-tissue contrast, MRI is able to visualize intracapsular synovitis [7,39,52] and is more sensitive in the detection of osteolytic lesions than radiographs or CT [50,51].…”

Section: Introductionmentioning

confidence: 99%

Early Reactive Synovitis and Osteolysis after Total Hip Arthroplasty

Cooper

Ranawat

Potter

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Little is known about intraarticular pathology following THA prior to the radiographic appearance of osteolysis, primarily due to imaging limitations. MRI has recently been applied to imaging the postarthroplasty hip with the ability to detect periarticular bony and soft tissue pathology; specifically, it is able to detect abnormal synovial patterns and focal bone loss well before the radiographic appearance of osteolysis. Questions/purposes We therefore used MRI to determine the incidence of early reactive synovitis and osteolysis in asymptomatic patients after THA, and whether there is an association between these MRI findings and clinical outcomes or radiographic wear measurements at this early stage. Methods We recruited 31 patients (33 hips) who underwent routine noncemented THA with one of three types of bearing surfaces: metal-on-cross-linked polyethylene (n = 7), ceramic-on-ceramic (n = 12), and ceramic-on-cross-linked polyethylene (n = 14). Patients underwent specialized MRI at a minimum of 12 months (mean, 23 months; range, 12-37 months) after surgery. MR images were analyzed for the presence of synovitis or osteolysis. WOMAC scores, patient assessment questionnaires, and radiographic wear measurements were correlated with MRI findings. Results Reactive synovitis was observed in 13 of 33 patients (39%) and focal osteolysis in one of 33 (3%). The presence of synovitis did not correlate with pain, activity level, patient satisfaction or clinical outcome scales, nor did it correlate with radiographic wear measurements at early followup. Conclusions Our observations suggest reactive synovitis is common yet asymptomatic at short-term followup. We do not know either the etiology or the long-term implications of these observations.

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Low-Field-Strength MR Imaging of Failed Hip Arthroplasty: Association of Femoral Periprosthetic Signal Intensity with Radiographic, Surgical, and Pathologic Findings

Abstract: Low-field-strength MR imaging depicted periprosthetic tissue signal intensity that was significantly associated with radiographic, surgical, and pathologic findings.

Cited by 30 publications

References 19 publications

MR Imaging of Hip Arthroplasty Implants

MR Imaging of Hip Arthroplasty Implants

Reduction of Metal Artifacts in Patients with Total Hip Arthroplasty with Slice-encoding Metal Artifact Correction and View-Angle Tilting MR Imaging

Early Reactive Synovitis and Osteolysis after Total Hip Arthroplasty

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