Related Experiment Video
Updated: Jan 31, 2026
Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
Published on: February 2, 2024
Combined MRI features to assess periprosthetic hip joint infection with STIR SEMAC and MAVRIC at 1.5 T
Fadila Mihoubi Bouvier1,2, Dominique Ngouana3, Gerard Morvan4
1Department of Radiology, Cochin University Hospital, University of Paris, 27 Rue du Faubourg Saint-Jacques, Paris, 75014, France. fadila.mihoubibouvier@aphp.fr.
Objective:
This study was aimed at identifying MRI findings related to total hip arthroplasty (THAs) infection using coronal STIR with metal artifact reduction sequences (MARS) at 1.5 T.
Materials And Methods:
This retrospective multicenter study included all patients with THAs who underwent 1.5 T MRI with MARS from December 2015 to April 2020. Two groups are as follows: an infected group and a non-infected group (including asymptomatic THAs and symptomatic non-infected THAs). MARS were either multi-acquisition with variable-resonance image combination (MAVRIC) or slice encoding for metal artifact correction (SEMAC). Imaging features were evaluated to assess their association with THA infection (including both symptomatic and asymptomatic patients). Sensitivity, specificity, and accuracy of these imaging findings were assessed, and inter-reader agreement (kappa, K) was determined.
Results:
Sixteen patients with THAs had periprosthetic infection, compared with 46 THAs in the non-infected group. Bone edema extending to adjacent soft tissues, defined as a combination of femoral bone marrow edema, hyperintense cortical signal, periostitis, and overall soft tissue edema, had the greatest diagnostic performance for infection: 15/16(94%) infected THAs and 0/46(0%) non-infected THAs (accuracy = 0.98, sensitivity = 0.94, specificity = 1, p < 0.001 Chi-Square test). This combination, predominant in the infected group (p < 0.001 for all), also demonstrated separately high accuracy (acc = 0.94-1), sensitivity (se = 0.94-1), and specificity (0.94-1). Fistula and fluid collection were highly specific (spe = 1) and accurate (acc = 0.81-0.82), although less sensitive (se = 0.25-0.31, p < 0.001).
Conclusion:
The combination of femoral bone marrow edema, hyperintense cortical signal, periostitis, and soft tissue edema is accurate in the diagnosis of periprosthetic hip joint infection using coronal STIR with MARs at 1.5 T.
Insights
A combination of MRI findings, including bone edema and soft tissue changes, accurately detects total hip arthroplasty infection. This imaging approach aids in diagnosing periprosthetic joint infections.
Area of Science:
- Radiology
- Orthopedic Surgery
- Medical Imaging
Background:
- Periprosthetic joint infection (PJI) is a serious complication of total hip arthroplasty (THA).
- Accurate diagnosis of THA infection is crucial for effective treatment and patient outcomes.
- Magnetic Resonance Imaging (MRI) with metal artifact reduction sequences (MARS) shows promise in evaluating THAs.
Purpose of the Study:
- To identify MRI findings associated with THA infection using coronal STIR with MARS at 1.5 T.
- To evaluate the diagnostic performance of specific imaging features for THA infection.
Main Methods:
- Retrospective multicenter study of patients with THAs undergoing 1.5 T MRI with MARS (MAVRIC or SEMAC).
- Patients were categorized into infected and non-infected groups.
- Imaging features were analyzed for association with THA infection, and diagnostic performance metrics (sensitivity, specificity, accuracy) were assessed.
Main Results:
- A combination of femoral bone marrow edema, hyperintense cortical signal, periostitis, and soft tissue edema demonstrated high diagnostic performance for infection (94% sensitivity, 100% specificity, 98% accuracy).
- Fistula and fluid collection were highly specific (100%) and accurate (81-82%) but less sensitive (25-31%).
- The combined edema pattern was significantly more prevalent in the infected group (p < 0.001).
Conclusions:
- Coronal STIR MRI with MARS at 1.5 T, particularly the combination of bone edema and soft tissue changes, is accurate for diagnosing periprosthetic hip joint infection.
- This imaging technique aids in differentiating infected from non-infected THAs.
- The findings support the use of this MRI protocol for evaluating suspected THA infections.
Related Concept Videos
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:16Structural Joints: Synovial Joints
01:03Structural Joints: Fibrous Joints
Suture
All the bones of the skull, except for the mandible, are joined to each other by a fibrous joint called a suture. The fibrous connective tissue found at a suture strongly unites the adjacent skull bones and thus helps to protect the brain and form the face. In...
01:17Structural Joints: Cartilaginous Joints
There are two types of cartilaginous joints:
Synchondrosis
A synchondrosis ("joined by cartilage") is a cartilaginous joint where bones are connected by hyaline cartilage. Synchondrosis may be temporary...
01:26Joints
Structural joint classifications are based on the material that makes up the joint as well as whether or not the joint contains a space between the bones. Joints are structurally classified as fibrous, cartilaginous, or synovial.
Fibrous Joints Are Immovable
The bones of a...
01:30Method of Joints
Since plane truss members are in the same plane, each joint is subjected to a coplanar and concurrent force system. To apply the method of joints, the first step is to...