Imaging orthopedic implant infections

Area of Science:

• Orthopedic surgery
• Medical imaging
• Infectious diseases

Background:

• Diagnosing orthopedic implant infections relies on clinical signs, lab results, and imaging.
• Conventional radiography is essential but often normal in early infection stages.

Purpose of the Study:

• To review diagnostic methods for orthopedic implant infections.
• To highlight the roles of various imaging modalities and needle aspiration.

Main Methods:

• Review of conventional radiography, CT, MRI, ultrasonography, and bone scintigraphy (BS).
• Discussion of labeled white blood cell (WBC) scintigraphy, colloid scintigraphy, and gallium scans.
• Emphasis on needle aspiration for definitive diagnosis.

Main Results:

• No single imaging technique is a gold standard for diagnosing orthopedic implant infections.
• CT, MRI, and ultrasonography are useful for soft tissue abnormalities.
• Labeled WBC scintigraphy is preferred for peripheral skeleton infections, while gallium scans are used for spine/pelvis.

Conclusions:

• A multimodal diagnostic approach is necessary for orthopedic implant infections.
• Needle aspiration with fluid analysis remains the definitive method for confirming infection.
• Accurate diagnosis is crucial for effective treatment and improved patient prognosis.