Improving the detection of acetabular osteolysis using oblique radiographs.
Visualisation of periacetabular osteolysis by standard anteroposterior (AP) radiographs underestimates the extent of bone loss around a metal-backed acetabular component. We have assessed the effectiveness of standard radiological views in depicting periacetabular osteolysis, and recommend additional projections which make these lesions more visible. This was accomplished using a computerised simulation of radiological views and a radiological analysis of simulated defects placed at regular intervals around the perimeter of a cadaver acetabulum. The AP view alone showed only 38% of the defects over all of the surface of the cup and failed to depict a 3 mm lesion over 83% of the cup. When combined with the AP view, additional 45 degree obturator-oblique and iliac-oblique projections increased the depiction, showing 81% of the defects. The addition of the 60 degree obturator-oblique view further improved the visualisation of posterior defects, increasing the rate of detection to 94%. Based on this analysis, we recommend using at least three radiographic views when assessing the presence and extent of acetabular osteolysis.
Southwell
D G
DG
Orthopaedic Biomechanics Laboratory, Midwest Orthopaedic Research Foundation, Minnesota, Minneapolis 55404, USA.
Bechtold
J E
JE
Lew
W D
WD
Schmidt
A H
AH
D000077:Acetabulum / Q000000981:diagnostic imaging*; D000368:Aged; D002102:Cadaver; D003198:Computer Simulation; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000000981:diagnostic imaging*; D011859:Radiography