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

  • General Review • HIP - ARTHROPLASTY
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

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.

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Authors and Affiliations

  1. Nuclear Medicine Department, Instituto Português de Oncologia Francisco Gentil, E.P.E. Lisbon, Rua Prof. Lima Basto, 1099-023, Lisbon, Portugal

    Sofia Vaz, Teresa C. Ferreira & Lucília Salgado

  2. Nuclear Medicine Department, Hôpital Lariboisière Assistance Publique-Hôpitaux de Paris, rue Ambroise-Paré 75475, Paris Cedex 10, France

    Frédéric Paycha

Authors
  1. Sofia Vaz
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  2. Teresa C. Ferreira
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  3. Lucília Salgado
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  4. Frédéric Paycha
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Correspondence to Sofia Vaz.

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Vaz, S., Ferreira, T.C., Salgado, L. et al. Bone scan usefulness in patients with painful hip or knee prosthesis: 10 situations that can cause pain, other than loosening and infection. Eur J Orthop Surg Traumatol 27, 147–156 (2017). https://doi.org/10.1007/s00590-016-1884-6

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  • DOI: https://doi.org/10.1007/s00590-016-1884-6

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