Abstract
Several complementary imaging modalities can be used to confirm or refute the diagnosis of prosthetic joint infection (PJI). These include plain films, fistulography, ultrasound, bone scintigraphy, computerized tomography scan (CT scan), magnetic resonance imaging (MRI), and positron electron tomography (PET). Plain radiographs and ultrasound are neither sensitive nor specific, and CT scan and MRI can be limited by hardware-induced artifacts. Bone scintigraphy is not affected by orthopedic hardware and is the current imaging modality of choice for suspected total knee arthroplasty (TKA) infection. Bone scintigraphy is sensitive for identifying the failed TKA but cannot be used to determine the cause of failure. SPECT/CT should be part of the routine diagnostic algorithm for patients with pain after TKA. The presence of lamellated hyperintense synovitis on MRI has a high sensitivity and specificity for infection. The current role of PET is still controversial, but it could be an appropriate alternative.
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Martín-Hervás, C., Rodríguez-Merchán, E.C. (2018). Diagnosis by Imaging of the Infected Total Knee Arthroplasty. In: Rodríguez-Merchán, E., Oussedik, S. (eds) The Infected Total Knee Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-319-66730-0_8
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