Radionuclide arthrography and transmission imaging for assessment of painful hip prostheses.
Interpretation of the radionuclide hip arthrogram may present difficulty because of a lack of anatomical reference information. Additional transmission images to determine tracer localization may facilitate scan interpretation.


METHODS
Isotope arthrography (20 MBq 99mTc-tin colloid and 57Co transmission imaging) was prospectively performed on 21 patients with painful hip prostheses and suspected stem loosening.


RESULTS
The radionuclide arthrogram was positive in 10 patients and negative in 9 patients. Extravasation of tracer, confirmed by transmission images, resulted in two nondiagnostic studies. Surgery was undertaken in 10 patients and loosening was confirmed in 6 patients. In this surgical subgroup, the scan was true-positive in six patients, true-negative in two patients, false-positive in one patient and nondiagnostic in one patient.


CONCLUSIONS
The combination of radionuclide arthrography and transmission imaging facilitates scan interpretation and is a recommended method for investigating suspected loosening of the femoral stem.
Hayes
A A
AA
Isotope Imaging, Surgicentre, South Perth, Australia.
Bower
G D
GD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D011446:Prospective Studies; D011475:Prosthesis Failure; D011877:Radionuclide Imaging; D017556:Technetium Compounds; D017971:Tin Compounds
D017556:Technetium Compounds; D017971:Tin Compounds; C033493:technetium Tc 99m tin colloid