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Imaging of prosthetic joints

Nuffield Orthopaedic Centre and Oxford Radcliffe Hospital, Oxford, UK

• Plain films are usually sufficient to assess the state of a prosthesis.
  
• Criteria for loosening depends on site and make of prosthesis.
  
• The wider and more extensive the periprosthetic lucency is, the higher the chance of loosening. Progressive changes are more significant.
  
• Scintigraphy is a sensitive but non specific technique for diagnosing loosening.
  
• Ultrasound and MRI are useful for assessing soft tissue collections.
  
• Diagnosing infection may require aspiration, biopsy or capsular frozen section.
  

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