Bone scan usefulness in patients with painful hip or knee prosthesis: 10 situations that can cause pain, other than loosening and infection

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• 作者：Sofia Vaz ; Teresa C. Ferreira…
• 关键词：Bone scan ; Bone SPECT/CT ; Painful prosthesis ; Loosening ; Infection ; Arthroplasty
• 刊名：European Journal of Orthopaedic Surgery & Traumatology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：27
• 期：2
• 页码：147-156
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Surgical Orthopedics; Traumatic Surgery;
• 出版者：Springer Paris
• ISSN：1432-1068
• 卷排序：27

文摘

In recent years, with the higher median life expectancy, the number of hip and knee replacements has increased. Clinical examination and morphological studies are essential to evaluate patients with a painful arthroplasty. Nuclear medicine examinations also play an important role, their main usefulness being the exclusion of prosthesis complications. Nevertheless, conventional examinations, namely bone scan and white blood cell scintigraphy, can also identify complications, such as loosening and infection. This study describes the normal and pathologic patterns of a bone scan and exemplifies ten common situations that can cause pain in patients with hip or knee arthroplasty, other than loosening and infection, which can be disclosed on a bone scintigraphy. The ten situations that should be considered and looked for when analysing a bone scan are: referred pain, patellofemoral pain syndrome, fractures, fissures, abscess/haematoma, bone insert behaviour, heterotopic ossification, greater trochanter pseudarthrosis, osteoarthritis extension in a knee with an unicompartmental prosthesis, and systemic disease with bone involvement.