[Study of a painful total hip prosthesis]

The authors propose a simple routine survey to be performed in the case of a painful total hip prosthesis which is generally able to define the diagnosis and the prognosis. X-ray films are more valuable by their repetition than by their simple analysis. Certain minor signs can help predict or detect loosening of the prosthesis or other complications, but in the great majority of cases, radiology alone is not sufficient to make the diagnosis, as the films are only able to show clear spaces around the prosthesis, without being able to definitely confirm the aetiopathogenic significance of this sign. In these cases, when the decision has not been taken to re-operate, more sophisticated investigations are required (scintigraphy, dynamic tests, arthrography), although they must be used with caution as very often the clinical findings will have the last word.