Radiology, Vol 162, 721-727, Copyright © 1987 by Radiological Society of North America
Arthrographic study of painful total hip arthroplasty: refined criteria
TP Maus, TH Berquist, CE Bender and JA Rand
The criteria for a diagnosis of loosening or infection of hip
arthroplasties on arthrographic study were further refined by a
retrospective review of 178 arthrograms representing 170 patients. The 97
arthroplasties that were surgically evaluated form the basis of this
report. With the refined criteria, subtraction arthrography had a
sensitivity of 96% and specificity of 92% for demonstrating loosening of
the femoral component and a sensitivity of 97% and a specificity of 68% for
demonstrating loosening of the acetabular component. Pseudocapsule size and
the presence of bursae were important factors influencing arthrographic
interpretation. Arthrographic findings of pseudocapsule irregularity and
the presence of nonbursal cavities were suggestive of infection but were
not sensitive or specific. Laboratory evaluation of aspirated material was
a more reliable predictor of infection, although its sensitivity was only
71%.
