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Radionuclide arthrography and transmission imaging for assessment of painful hip prostheses
Unlabelled:
Interpretation of the radionuclide hip arthrogram may present difficulty because of a lack of anatomical reference information. Additional transmission images to determine tracer localization may facilitate scan interpretation.
Methods:
Isotope arthrography (20 MBq 99mTc-tin colloid and 57Co transmission imaging) was prospectively performed on 21 patients with painful hip prostheses and suspected stem loosening.
Results:
The radionuclide arthrogram was positive in 10 patients and negative in 9 patients. Extravasation of tracer, confirmed by transmission images, resulted in two nondiagnostic studies. Surgery was undertaken in 10 patients and loosening was confirmed in 6 patients. In this surgical subgroup, the scan was true-positive in six patients, true-negative in two patients, false-positive in one patient and nondiagnostic in one patient.
Conclusions:
The combination of radionuclide arthrography and transmission imaging facilitates scan interpretation and is a recommended method for investigating suspected loosening of the femoral stem.