title: Trunnionosis: the latest culprit in adverse reactions to metal debris following hip arthroplasty.
abstract: The imaging findings of periprosthetic soft tissue lesions (pseudotumours) have been typically defined in the context of newer second-generation metal-on-metal hip arthroplasty. More recently, similar findings have been described in the setting of non-metal-on-metal prostheses. Although uncommon, wear and corrosion between the metal surfaces at the head-neck ('trunnionosis') and neck-stem interfaces are the potential culprits. With modular junctions containing at least one cobalt chromium component frequently present in hip arthroplasty prostheses, the incidence of this mode of adverse wear may be higher than previously thought (irrespective of the specific bearing couple used). In the present report, we described a case of a severe adverse local tissue reaction secondary to suspected corrosion at the head-neck taper in a metal-on-polyethylene total hip arthroplasty and reviewed the literature. Knowledge of this topical entity should help radiologists facilitate early diagnosis and ensure early management of this potentially serious complication.
authors.affiliation: Joint Department of Medical Imaging, University Health Network and Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, ON, Canada, M5G 1X5, ryans79@hotmail.com.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Shulman
authors.forename: Michael G
authors.initials: MG
authors.lastname: Zywiel
authors.forename: Rajiv
authors.initials: R
authors.lastname: Gandhi
authors.forename: J Roderick
authors.initials: JR
authors.lastname: Davey
authors.forename: David C
authors.initials: DC
authors.lastname: Salonen
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D006104:Granuloma, Plasma Cell / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008670:Metals / Q000009:adverse effects*; D011859:Radiography
chemical_list: D008670:Metals
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