This Article Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Miles, K. A. Articles by Belton, I. Search for Related Content PubMed PubMed Citation Articles by Miles, K. A. Articles by Belton, I.

Scintigraphic abnormalities in patients with painful hip replacements treated conservatively

K. A. Miles, FRCR W. M. Harper, FRCS ED ^* D. B. L. Finlay, MRCP, FRCR and I. Belton, BSc, MSc, MIPSM

Department of Radiology, Leicester Royal Infirmary Infirmary Square, Leicester, UK ^* Department of Orthopaedics, Leicester Royal Infirmary, Infirmary Square, Leicester, UK Department Medical Physics, Leicester Royal Infirmary, Infirmary Square, Leicester, UK

A retrospective review of the scintigraphic appearances of 98 painful hip replacements was made. 16 patients (16%) underwent revision surgery whereas in the remaining 82 hips (84%), symptoms settled with conservative management. 73 of these (89%) had at least one area of increased activity on delayed diphosphonate scintigraphy with 27% having increased activity in three or more areas around the femoral component. Hips with increased activity at the lesser trochanter and tip were less likely to undergo spontaneous resolution of symptoms. Uncemented prostheses were more likely to have multiple areas of increased activity. Abnormalities in dynamic bone scintigraphy and gallium studies were also seen in patients whose symptoms resolved without surgery. Whereas a normal bone scintigram indicates that loosening or infection is most unlikely, the presence of increased activity does not necessarily indicate a need for revision surgery, even when multiple areas are present. A period of conservative management should be considered before operative intervention is undertaken.

Key Words: Hip • Prosthesis • Radionuclide • Imaging • Management

Received for publication July 1, 1991. Revision received October 30, 1991. Accepted for publication January 14, 1992.

This article has been cited by other articles:

				M. S. Davenport, R. K. J. Brown, and K. A. Frey Utility of Delayed Whole-Body Bone Scintigraphy After Directed Three-Phase Scintigraphy Am. J. Roentgenol., August 1, 2009; 193(2): 338 - 342. [Abstract] [Full Text] [PDF]