Evaluating Hip Periprosthetic Joint Infection with Metal-artifact-reduction MR Imaging.

Area of Science:

• Orthopedic imaging
• Radiology
• Infectious disease diagnostics

Background:

• Periprosthetic joint infection (PJI) is a serious complication of hip arthroplasty.
• Accurate diagnosis of hip PJI is crucial for effective treatment and patient outcomes.
• Metal artifacts from orthopedic implants can hinder diagnostic imaging accuracy.

Purpose of the Study:

• To evaluate significant findings of hip PJI using metal-artifact-reduction (MAR) MRI.
• To compare the diagnostic performance of MAR MRI with other clinical markers for hip PJI.
• To identify key imaging features indicative of hip PJI on MAR MRI.

Main Methods:

• Retrospective assessment of 1.5T MAR MRI scans (2D fast-spin echo, increased bandwidth) in patients with hip implants.
• Analysis of imaging findings and diagnostic impressions by two radiologists.
• Comparison of MRI results with clinical data and outcomes using univariate and multivariate analyses.

Main Results:

• MAR MRI identified significant findings for hip PJI, including acetabular periosteal edema, intermuscular edema, intramuscular fluid collection, and lymphadenopathy.
• In cases with surgical intervention, findings included capsular distension/thickening, femoral osteolysis-like pattern, subcutaneous fluid collection, and lymphadenopathy.
• MAR MRI demonstrated high diagnostic significance for hip PJI, surpassing other clinical markers in accuracy.

Conclusions:

• Acetabular periosteal edema, intermuscular edema, intramuscular fluid collection, and lymphadenopathy are significant MRI findings for hip PJI.
• Capsular changes, femoral osteolysis-like patterns, subcutaneous fluid, and lymphadenopathy are key indicators in surgically treated cases.
• MAR MRI is a highly valuable tool for diagnosing hip PJI, offering superior diagnostic performance.