title: Clinical Usefulness of SPECT-CT in Patients with an Unexplained Pain in Metal on Metal (MOM) Total Hip Arthroplasty.
abstract: SPECT-CT is increasingly used to assess painful knee arthroplasties. The aim of this study was to evaluate the clinical usefulness of SPECT-CT in unexplained painful MOM hip arthroplasty. We compared the diagnosis and management plan for 19 prosthetic MOM hips in 15 subjects with unexplained pain before and after SPECT-CT. SPECT-CT changed the management decision in 13 (68%) subjects, Chi-Square=5.49, P=0.24. In 6 subjects (32%) pain remained unexplained however the result reassured the surgeon to continue with non-operative management. SPECT-CT should be reserved as a specialist test to help identify possible causes of pain where conventional investigations have failed. It can help reassure surgeons making management decisions for patients with unexplained pain following MOM hip arthroplasty.
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science (University College London) and the Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex.
authors.forename: Reshid
authors.initials: R
authors.lastname: Berber
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science (University College London) and the Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex.
authors.forename: Johann
authors.initials: J
authors.lastname: Henckel
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science (University College London) and the Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex.
authors.forename: Michael
authors.initials: M
authors.lastname: Khoo
authors.affiliation: Institute of Nuclear Medicine, T5, University College Hospital, London.
authors.forename: Simon
authors.initials: S
authors.lastname: Wan
authors.affiliation: School of Science and Technology, Natural Sciences Department, Middlesex University London, The Burroughs, London.
authors.forename: Jia
authors.initials: J
authors.lastname: Hua
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science (University College London) and the Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex.
authors.forename: John
authors.initials: J
authors.lastname: Skinner
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science (University College London) and the Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex.
authors.forename: Alister
authors.initials: A
authors.lastname: Hart
mesh_terms: D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000000981:diagnostic imaging* / Q000209:etiology; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D061825:Metal-on-Metal Joint Prostheses; D008875:Middle Aged; D010147:Pain Measurement; D011475:Prosthesis Failure; D012086:Reoperation; D015899:Tomography, Emission-Computed, Single-Photon
keywords: SPECT–CT; arthroplasty; diagnosis; hip; pain; unexplained