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Area of Science:

  • Nuclear medicine
  • Radiology
  • Orthopedics

Background:

  • Pain after total joint arthroplasty (TJA) can stem from infection or loosening.
  • Accurate diagnosis is crucial for effective patient management.

Purpose of the Study:

  • To review the role of nuclear medicine and other imaging modalities in evaluating pain after TJA.
  • To discuss the diagnostic utility and limitations of various imaging techniques.

Main Methods:

  • Review of nuclear medicine studies including 3-phase bone scans and labeled leukocyte scintigraphy.
  • Discussion of advanced imaging techniques such as MRI, SPECT/CT, and PET/CT.

Main Results:

  • 3-phase bone scans are a potential first-line study for TJA pain.
  • Labeled leukocyte scintigraphy aids in suspected infections when other tests are inconclusive.
  • Nuclear studies may yield false positives for up to two years post-TJA due to bone remodeling.

Conclusions:

  • While 3-phase bone scans are useful, advanced techniques like SPECT/CT, PET/CT, and MRI show future promise for TJA pain diagnosis.
  • Further research is needed to define the optimal role of these advanced modalities.