What imaging findings suggest prosthetic joint infection septic arthritis?

Updated: Sep 03, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

In prosthetic joint infection [PJI], plain radiography can reveal new subperiosteal bone growth and transcortical sinus tracts. [2, 37] These findings are specific for infection. Arthrography can demonstrate loosening of the prosthesis and abscesses. Nuclear scans of all types are of limited diagnostic use in patients with prosthetic joint infection, and MRIs are limited by the type of implanted material (this diagnostic modality can safely image only titanium or tantalum devices). Fludeoxyglucose-positron emission tomography (FDG-PET) scans may hold some promise in diagnosing lower-extremity prosthetic joint infections. However, this approach cannot differentiate aseptic loosening from infection. Sensitivity and specificity were 87% and 82%, respectively. [37] CT scans are useful in ascertaining the state of the surrounding soft tissue.


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