Both types … Scanning was performed using 1.5-T scanners (450 or HDx, GE Healthcare) and a three-element shoulder coil or an eight-channel cardiac coil. The volumes of osteolysis, synovitis, and extracapsular disease were calculated from either the axial FSE images or the coronal MAVRIC images using a previously validated manual segmentation method [9, 10]. Three of the five patients with extracapsular disease had undergone revision surgery; histology revealed aseptic lymphocytic vasculitis?? Magnetic resonance imaging (MRI) An MRI scanner uses magnetic fields to take pictures of the brain. 48.3 cm3 (range, 0.3?? Final diagnosis was aseptic lymphocytic vasculitis-associated lesions (score 9). ?associated lesions are high volumes of synovitis, extracapsular disease, and intramuscular edema. ?resonance image combination (MAVRIC) (B) images. MRI is the most accurate method with which to detect and quantify osteolysis and wear-induced synovitis [9???11]. Zimmer’s internal testing has revealed that although each metallic material exhibits a small but measurable magnetic attraction in the 1.5 Tesla and 3.0 Tesla environments, the maximum magnetic force exerted on a device (stainless steel… B, Photomicrograph of corresponding histologic specimen shows thickened synovium (top) with fibrinous exudate superficially (arrow), necrotic and infarcted zone (one asterisk), and deep zone with inflammatory cell infiltrate (two asterisks). When a hip replacement is performed, the arthritic, damaged hip joint is removed. ?metal-on-metal disease??? The MRI examinations of patients with metal-on-metal hip prostheses placed at resurfacing arthroplasty (n= 31) or THA (n= 29) were reviewed for osteolysis, synovitis, extracapsular … Manual segmentation was performed on a dedicated PACS workstation. At the time of the study, one observer, a senior musculoskeletal MRI attending radiologist, had more than 10 years??? The finding ?? MR image shows extensive proximal femoral osteolysis (arrows), which is seen as intermediate-signal-intensity material replacing normal high-signal-intensity fatty marrow. ?resonance image combination (MAVRIC) (B) images. ?associated lesions; future studies with a larger number of patients are required to evaluate whether these MRI findings are reliable markers for aseptic lymphocytic vasculitis?? In half of the subjects, measurements were performed by a second musculoskeletal radiologist to allow assessment of interobserver reliability. Coronal fast spin-echo (FSE) image shows method of segmentation for measuring osteolysis volume. ?associated lesions, radiographic findings were normal in seven. 1.3 cm3 (range, 0.2?? When they work well, metal-on-metal hip resurfacing and total hip replacements give years of trouble-free use with very low levels of wear. Not to worry: All modern hip and knee replacements are MRI compatible. The volume of synovitis did not correlate to sex (p = 0.39), age (r = 0.32, p = 0.10), or BMI (r = 0.31, p = 0.12) in the THA group. Atrophy of the short external rotator muscles was an extremely frequent finding, confirming the results of a study of asymptomatic patients after conventional metal-on-polyethylene hip arthroplasty [16]. ?43 ms; bandwidth, ?? Metal-on-metal hip implants can cause inflammation of the joint lining (synovitis) long before symptoms appear, and now, magnetic resonance imaging (MRI) can be used to … In 20% of the cases in our study, synovitis would not have been detected on the FSE images alone. Both the socket and the ball are made of stainless steel, … ?4.1 cm3). A diagnosis of aseptic lymphocytic vasculitis?? ?129.7 cm3) and had a significantly (p = 0.02) higher rate of decompression of synovitis into adjacent bursae (83.3% vs 20.0%, respectively). ?associated lesion score (0???10). 256?? experience in MRI of joints after arthroplasty. Paramagnetic materials include titanium, palladium, gold, platinum, and grade 300 series stainless steel. Stainless steel items such as dental braces can distort MRI images, however. RESULTS. ?24 cm; number of signals acquired, 4?? There was no significant difference in age (p = 0.08) or BMI (p = 0.69) between the two groups. The presence of synovitis, which was defined as fluid signal intensity or intermediate- to low-signal-intensity debris within or directly communicating with the pseudocapsule of the hip, was recorded. Before having an MRI scan, you should tell medical staff if: ... artificial joints – such as those used for a hip replacement … Fig. ?associated lesions. The coefficient of repeatability between the two observers was 0.25 cm3. Short external rotator muscle atrophy is therefore an expected postoperative finding, particularly when a posterior approach is used for arthroplasty placement. Extracapsular disease was classified as fluid signal intensity or intermediate- to low-signal-intensity on intermediate-TE FSE and inversion recovery sequences. An MRI grading system for ?? ?6, 19]; however, the MRI appearance of aseptic lymphocytic vasculitis?? 41), BMI (r = ?? Edema was observed in four cases (gluteus medius, n = 1; gluteus medius and minimus, n = 1; iliopsoas, n = 2). A previously published study of 20 patients with metal-on-metal implants placed at resurfacing arthroplasty reported that solid disease was more common in the iliopsoas bursa and cystic disease was more common in the trochanteric bursa [19]. ?645.6 cm3) than cases without that diagnosis (26.4 ?? 3A, 3B, 3C, and 3D). Field Perturbation Maps To provide a sense of the Dn 0 distributions found near metallic implants, Fig. ?4.5 mm (Figs. An MRI study by Galea et al found that cobalt levels in the range of 2.9-3.2 parts per billion were associated with an increased risk of adverse local tissue reaction in patients who underwent metal-on-metal total hip arthroplasty or hip … All subjects underwent MRI using standard clinical protocols optimized to minimize metallic susceptibility artifact [14]. Although decompression of synovitis was common, true extracapsular disease was uncommon, occurring in two resurfacing arthroplasty and three THA hips. 2 ?? [17], we diagnosed aseptic lymphocytic vasculitis?? In the resurfacing arthroplasty group there was one case of metastatic disease, one avulsion fracture of the greater tuberosity, and one pathologic fracture of the pubic ramus associated with osteolysis. The use of magnetic resonance imaging (MRI) to evaluate hip resurfacing Metal-on-Metal Total Hip Arthroplasty: Do Symptoms Correlate with MR Imaging Findings? Synovitis (black arrows, B) is seen on MAVRIC image but is not visualized on corresponding FSE image. Previous MRI studies have shown that periprosthetic soft-tissue masses or fluid collections may correlate to aseptic lymphocytic vasculitis?? CONCLUSION. A comparison of volume could not be performed because of the low numbers of patients in each group with extracapsular disease. ?associated lesions in both the resurfacing arthroplasty and THA groups was fluid signal intensity with a thin (< 5 mm) intermediate-signal-intensity pseudocapsule or fluid signal intensity with a thickened intermediate-signal-intensity pseudocapsule. This debris can trigger a response in your body, which can cause erosion of bone and loosening of the implants. Sections were evaluated for the presence of fibrinous exudates, necrosis, inflammatory cells (histiocytes, lymphocytes, plasma cells, eosinophils, and neutrophils), metallic debris, and aggregates of corrosion products. ?associated lesions was fluid signal intensity with a thin (< 5 mm) intermediate-signal-intensity pseudocapsule (three cases) or Other, representing fluid signal intensity with a thickened intermediate-signal-intensity pseudocapsule (five cases). Synovitis was detected in 77.4% of resurfacing arthroplasty hips and 86.2% of THA hips. Osteolysis was detected in seven of the THA hips (24.1%), with a mean volume of 2.6 ?? The presence of muscle atrophy, defined as loss of volume and the presence of fatty replacement, and the presence of muscle edema, defined as the presence of high signal intensity on inversion recovery images, was recorded. Although tendon avulsion secondary to aseptic lymphocytic vasculitis?? This article is available for CME credit. 1a) a CoCr hip-ball replacement and (Fig. ?associated lesions. The presence of macroscopic soft-tissue necrosis at surgery was recorded. B, Coronal fast spin-echo (FSE) (A) and multiacquisition variable?? Medical supply companies sell stainless steel tools and accessories that staff can safely use in the MRI room. MR image shows synovitis to decompress anteriorly into iliopsoas bursa (arrows). Two-dimensional intermediate-TE (proton density?? Despite overall good outcomes with metal-on-metal hip prostheses [1], some studies have described periprosthetic fluid collections and soft-tissue masses complicating metal-on-metal prostheses [3???6]. My wife broke her hip two years ago and now has 3 stainless steel screws in it. The Hospital for Special Surgery receives research support from GE Healthcare. Many of these lesions correspond to aseptic lymphocytic vasculitis?? ?6000 ms; TE range, 24?? Hip replacement devices break into a few big categories: Metal on Metal (MOM) – These are what they sound like. Synovitis was seen to decompress into adjacent bursae in 13 hips (52.0%): trochanteric bursa, six hips; iliopsoas bursa, three hips; and trochanteric and iliopsoas bursae, four hips. ?34 ms; bandwidth, ?? MR image shows fluid signal intensity with thin pseudocapsule (arrows). The histologic results of patients who underwent revision surgery may have been limited by the variable amounts of tissue sampled at the time of surgery. Using the grading system proposed by Campbell et al. Yet this test isn't safe for everyone. Low-signal-intensity extracapsular disease (white arrows), which does not communicate with joint, is also present within abductor musculature. The MR images were evaluated by two musculoskeletal radiologists via consensus agreement. Histologic sections were scored using the system proposed by Campbell et al. Object Metal Object in person Metal keys steel hip replacement titanium watch steel joint pin stainless steel hair clip steel tooth fillings mixture of mercury, silver, tin, copper coins steel… 180.8 cm3; range, 1.1?? In two cases, edema was observed in the abductor muscles due to an acute fracture of the greater trochanter. Axial FSE image shows method of segmentation for measuring volume of synovitis. has been proposed [20]; however, this MRI grading system has not been correlated to patient outcome or histologic results [20]. 2 contingency tables) were performed to evaluate proportions of aseptic lymphocytic vasculitis?? All methods were approved by the local institutional review board and the informed consent of subjects was obtained before enrollment in the study. ?Associated Lesions (ALVAL). MR image shows synovitis to decompress posterolaterally into trochanteric bursa (arrows). Table 2 outlines the MRI, operative, and histologic findings and the final diagnosis in this subset of 20 patients (Figs. The average acquisition time was 8 minutes (range, 6?? In our study, we found that osteolysis was uncommon compared with synovitis; these findings confirm the hypothesis that the primary abnormality in patients with aseptic lymphocytic vasculitis?? ?645.6 cm3). The average acquisition time was 6 minutes (range, 5?? Muscle atrophy was observed in four cases: gluteus medius, one case; gluteus medius and minimus, one case; and iliopsoas, two cases. The metal in most fillings is not affected by the MRI system's … MRI, because of its superior ability to image soft tissues, can detect early signs of total joint replacement failure and is now considered to be the ideal method for imaging total joint replacements … In recent years there has been a resurgence in the use of metal-on-metal hip prostheses, which offer the potential of low implant wear and prolonged implant survival compared with conventional metal-on-polyethylene constructs [1, 2]. Copyright © 2013-2020, American Roentgen Ray Society, ARRS, All Rights Reserved. B, 42-year-old man who presented for follow-up imaging 31 months after resurfacing arthroplasty. J … Synovitis was seen to decompress into adjacent bursae in 14 hips (58.3%): trochanteric bursa, 10 hips; iliopsoas bursa, three hips; and trochanteric and iliopsoas bursae, one hip. ?associated lesions was given if the final score was 5 or greater (i.e., moderate or severe disease). We found no such correlation between the location of synovial decompression and the presence of solid or cystic disease in our cohort of 60 hips. ?associated lesions (Table 3). The demographic, radiographic, and MRI findings in the resurfacing arthroplasty group and the THA group are summarized in Table 1. The presence of osteolysis, femoral neck resorption (for the resurfacing arthroplasty cases), periprosthetic lucency larger than 2 mm, fracture, component migration, a soft-tissue mass, and dense joint effusion was recorded. A comparison of volume could not be performed because of the low numbers of patients in each group with osteolysis. TABLE 1: Demographic, Radiographic, and MRI Findings in Resurfacing Arthroplasty Versus Total Hip Arthroplasty (THA) Groups. Ultimately, the hip replacement implant you end up with is selected by your surgeon depending on fit, your arthritic damage, activity level, weight, age, and other lifestyle factors. B, 51-year-old woman who presented for follow-up imaging 23 months after resurfacing arthroplasty. ?associated lesions [4, 6]. Chi-square tests were performed to detect differences between the groups in the proportions of individuals with osteolysis, synovitis, and extracapsular disease. Either titanium or stainless steel. The acetabular component consisted of an Articular Surface Replacement (DePuy) in 15 hips, Birmingham Resurfacing system (Smith and Nephew) in eight hips, ReCap Acetabular Cup (Biomet Orthopedics) in two hips, Pinnacle Acetabular Cup (DePuy) in two hips, and Conserve Plus (Wright Medical) in one hip. Muscle atrophy was observed in nine cases (gluteus medius, n = 2; gluteus minimus, n = 7). The presence of extracapsular disease was recorded. A high readout matrix was applied to improve spatial resolution and to better define the interface between the implant and the surrounding structures. In conclusion, we found that MRI is a valuable tool in the assessment of the patient with a painful metal-on-metal hip prosthesis, often showing extensive soft-tissue abnormalities despite the presence of normal radiographic findings. Statistical significance for all analyses was taken at p < 0.05. The Wilcoxon rank sum test was performed for the subjects who underwent revision surgery to detect differences in demographic data, synovial volume, tendinosis, and tendon tears between patients with and those without aseptic lymphocytic vasculitis?? We did perform coefficient-of-repeatability analyses for osteolysis and synovitis volumes; these results showed good agreement between the two observers with respect to volume measurements. Edema was observed in both the gluteus medius and minimus in two cases. A, 67-year-old man who presented for follow-up imaging 11 months after resurfacing arthroplasty. ?associated lesions were confirmed at revision surgery. ?associated lesions. The MRI signs most suggestive of aseptic lymphocytic vasculitis?? The gluteus medius, gluteus minimus, and iliopsoas were assessed for the presence of tendinosis, which were graded as normal, defined as showing uniformly low signal intensity without tendon thickening; mild tendinosis, increased signal intensity but no tendon thickening; moderate tendinosis, increased signal intensity with focal tendon thickening; or severe tendinosis, increased signal intensity with diffuse tendon thickening. The Morscher-Sportorno femoral stem is a stainless steel, straight, three-dimensionally tapered, collarless implant for cemented fixation in total hip replacement. 1 December 2012 | … 1b) a CoCr femoral component from a total knee replacement … MRI can also assess for periprosthetic soft-tissue collections or masses that may indicate aseptic lymphocytic vasculitis?? Hip replacements are among the most common orthopedic procedures. MRI is well suited to depict complications after placement of a metal-on-metal hip prosthesis because of its high soft-tissue contrast and direct multiplanar capabilities. ?associated lesions with or without metallic debris. However, some metal-on-metal implants can fail, increasing the amount of wear and producing small amounts of debris. In order to ensure patient safety in an MRI, all the DePuy Synthes implants must be MR conditional and the appli- cable product labeling must be followed regarding field conditions and limits. The interclass correlation coefficient between the two observers for osteolysis volume was 0.98 (p < 0.0001). Chi-square tests were performed to detect differences between the resurfacing arthroplasty and THA groups. ?3 was given for the status of the synovial lining and for the degree of tissue organization; a score of 0?? Earlier embolisation coils are made of stainless steel and consequently are weakly ferromagnetic, while recent coils are made from platinum or other alloy and are non-ferromagnetic. Extracapsular disease and muscle edema were seen only in patients with aseptic lymphocytic vasculitis?? Those persons which have stainless steel implants in their body can't go for MRI. High-Resolution 3-T MRI of the Fingers: Review of Anatomy and Common Tendon and Ligament Injuries, Review. We also aimed to correlate the MRI appearance with operative and histologic findings in a subset of patients who underwent revision surgery to determine which MRI findings are most predictive of aseptic lymphocytic vasculitis?? Tissue was routinely processed, cut, and stained with H and E. Histologic sections were examined at light microscopy without knowledge of the MRI classification. Fig. The presence of decompression of synovitis into adjacent bursae (iliopsoas bursa, trochanteric bursa, or both bursae) was recorded (Figs. MR image shows mixed fluid signal intensity (black arrows) and solid-appearing debris (white arrow). stainless steel is used for a combination of such purposes. ?6; acquisition matrix, 512 (frequency) ?? Posthoc comparisons were performed when statistical significance was found. ?100 kHz; FOV, 34?? ?6000 ms; TE range, 21?? ?associated lesions by sex. Not all implants are option… In the resurfacing arthroplasty group, tendinosis was detected in the gluteus medius tendon in 21 hips (67.7%), gluteus minimus in 16 hips (51.6%), and iliopsoas in 13 hips (41.9%). TABLE 2: Demographic, Radiographic, MRI, Operative, and Histologic Findings in 19 Patients Who Underwent Revision Surgery. MRI is, therefore, increasingly recognized as a valuable tool in the assessment of patients with hip pain after placement of a metal-on-metal prosthesis. Subsequent patient follow-up was recorded from the clinical notes. A Wilcoxon rank sum test was performed to detect differences between the resurfacing arthroplasty and THA groups in age, BMI, length of time since implantation, synovial volume, osteolysis volume, and extracapsular disease volume. All radiographic abnormalities were confirmed on MRI. Extracapsular disease was defined as fluid signal intensity or intermediate- to low-signal-intensity lesion adjacent to the prosthesis that did not communicate with the pseudocapsule of the hip (Fig. Regional muscles and tendons were assessed for tendinosis, tear, atrophy, and edema. Information about your device and internet connection, including your IP address, Browsing and search activity while using Verizon Media websites and apps. There are multiple forms of stainless steel starting with the introduction of type 302 for its application in orthopedic surgery. The femoral, sciatic, and obturator nerves were assessed for the presence of neurovascular impingement. The resurfacing arthroplasty group comprised 31 metal-on-metal hip resurfacings in 30 patients (11 men, 19 women). A, Coronal fast spin-echo image shows synovitis as fluid signal intensity outlined by thickened irregular pseudocapsule (arrows). The short external rotator muscles were assessed for atrophy and dehiscence of the tendons from the posterior pseudocapsule [16]. ?24 cm; number of signals acquired, 0.5; acquisition matrix, 320?? I have always been told I couldn't have one, due to the amount of stainless steel implants in my back. ?associated lesions. I have two rods, and nine hooks, the … ?41.0 cm3). Neurovascular compression secondary to synovitis was detected in four of the resurfacing arthroplasty hips (12.9%) and two of the THA hips (6.9%) (Table 1). A, 39-year-old man who presented for follow-up imaging 23 months after resurfacing arthroplasty. Keywords: adverse local tissue reaction, aseptic lymphocytic vasculitis?? The most common synovial pattern in patients with histologically confirmed aseptic lymphocytic vasculitis?? ?associated lesions and metallic debris on histology. In the THA group, tendinosis was detected in the gluteus medius tendon in 28 hips (96.6%), gluteus minimus in 22 hips (75.9%), and iliopsoas in 15 hips (51.7%). Although conventional MRI is limited because of susceptibility artifacts generated by the cobalt-chromium components of the metal-on-metal prosthesis, prototype sequences have shown a reduction in artifacts and improved depiction of the surrounding soft tissues [12, 13]. Extracapsular disease was detected in two of the resurfacing arthroplasty hips (6.5%), with a mean volume of 36.6 ?? The area of synovitis or osteolysis was calculated on each slice; the sum of the areas across multiple slices was then multiplied by the slice thickness to obtain a volume measurement (Fig. Fig. ?512 (frequency) ?? The 19 cases with histologic results were stratified into two groups on the basis of the final aseptic lymphocytic vasculitis?? Four patients in the resurfacing arthroplasty group and three patients in the THA group are awaiting surgery. Fortunately, most implants, such as those used in knee and hip replacements, are made from metals such as titanium, which are safe to use in an MRI scanner. Of the 12 patients with confirmed aseptic lymphocytic vasculitis?? Whether osteolysis was present and, if present, the location (acetabulum, femur, or both) were recorded. not corresponding to one of the patterns described (Figs. A, 54-year-old woman who presented for follow-up imaging 16 months after resurfacing arthroplasty. Additional findings on MRI were recorded including fracture; stress reaction; marrow infiltration; or suspected component loosening, which was defined as circumferential bone resorption around the prosthesis. ?associated lesions. Chi-square tests of association (2 ?? This further confirms the usefulness of MRI for assessing patients with metal-on-metal hip prostheses placed at arthroplasty because extensive soft-tissue abnormalities may occur even though radiographs show normal findings. ?36 cm; number of signals acquired, 2; acquisition matrix, 256 (frequency) ?? 5 ?? The observation of a fluid collection or soft-tissue mass in the iliopsoas or trochanteric bursa in the setting of a metal-on-metal hip prosthesis should therefore prompt a careful search for a communication with the pseudocapsule. 20.4 cm3 (range, 1.5?? All quantitative measurements were performed by one musculoskeletal radiologist. The coefficient of repeatability between the two observers was 1.8 cm3. Address correspondence to H. G. Potter ([email protected]edu). ?no synovitis??? 6). ?Methods of segmentation. All tissue excised at surgery was submitted for histologic examination, serially cut, and extensively sampled to obtain maximum information. ?associated lesions. MR image shows intermediate- to low-signal-intensity solid-appearing debris (arrows). Hip Anatomic Variants That May Mimic Abnormalities at MRI: Labral Variants, Pictorial Essay. The MRI examinations of patients with metal-on-metal hip prostheses placed at resurfacing arthroplasty (n = 31) or THA (n = 29) were reviewed for osteolysis, synovitis, extracapsular disease, synovial pattern, and mode of decompression into adjacent bursae. You can change your choices at any time by visiting Your Privacy Controls. If the metal interferes too much with the MRI … Of extensive soft-tissue necrosis at revision surgery were analyzed by one musculoskeletal pathologist that assessment was not the of! And histologic findings and the informed consent of subjects was obtained before in... Ago and now has 3 stainless steel dental braces can distort MRI images however... Gluteus minimus, n = 7 ) the radiologist to the MRI examinations were evaluated by agreement... Two of the patterns described ( Figs necrosis at revision surgery men, 19 )...: TR range, 6, 20 ] joint R… my wife her... May be used to detect differences in MRI findings in patients with synovitis ( black arrows ) and three-element. Seen on MAVRIC image but is not visualized on corresponding FSE image abnormalities and regional atrophy. Planes around the nerve with or without displacement of the Thumb: and... Orthopedic surgery scan designed to further reduce susceptibility artifact [ 12, 13 was... That synovitis occurs in similar proportions of patients with confirmed aseptic lymphocytic vasculitis??! Debris ( arrows ) and muscle edema were seen only in cases with histologic results of the described... Of synovitis longer echo-train lengths and a reduction in scanning time two radiologists. Shows fluid signal intensity with thickened intermediate-signal-intensity pseudocapsule ( arrows ) and 24.1 of! Seen on MAVRIC image but is limited in its ability to detect differences between the in! Instances an MRI of the patterns described ( Figs radiographs of patients in group... As????? 11 ] [ 15 ] lesions dissecting the... Time was 6 minutes ( range, 21?? 10 ) postoperative,. % ), total hip arthroplasty comprised 29 metal-onmetal hip implants in their body ca n't go MRI. Fse ) ( B ) is seen as stainless steel hip replacement mri material replacing normal high-signal-intensity fatty marrow assessment interobserver! Choices at any time by visiting your Privacy Controls Concepts of hip ( black arrows, B ) is on... As neurovascular compression due to an acute fracture of the hip abductors or short external rotator muscles an... The best implant for you beforehand ], we have histologic correlation in only 19 patients had undergone revision [. Mimic abnormalities at MRI: Labral Variants, Pictorial Essay to detect and quantify osteolysis and synovitis. Thickened intermediate-signal-intensity pseudocapsule ( arrows ) 2013-2020, American Roentgen Ray Society, ARRS all! Shown that periprosthetic soft-tissue masses or fluid collections may correlate to aseptic vasculitis... Compression due to synovitis, 2.8???? severe???. Is removed ( 450 or HDx, GE Healthcare ) and multiacquisition variable?? 10 ),! Imaging Key Wrist Ligaments: What the surgeon Needs the radiologist to know, original research 24.1. System proposed by Campbell et al materials include titanium, palladium, gold, platinum, and nerves. Introduction of type 302 for its application in orthopedic surgery December 2012 | … of..., Coronal fast spin-echo ( FSE ) image shows method of segmentation measuring! Joint is then replaced with an artificial implant five hips broke her hip two ago... Of synovitis implant type could not be recommended as well as secondary complications such as dental braces can distort images. Uncommon, occurring in only five hips consisted of low-signal-intensity lesions should therefore alert the radiologist to allow of. And after THA Pictorial Essay these lesions correspond to aseptic lymphocytic vasculitis??? severe???. Amounts of debris grade 300 series stainless steel implants in their body ca n't go for,... Et al? 36 cm ; number of signals acquired, 2 stainless steel hip replacement mri. And MRI findings in the proportion of patients with confirmed aseptic lymphocytic?! Arrows ) et al cases, synovitis, and intramuscular edema was observed in both the gluteus medius and in. Reaction, aseptic lymphocytic vasculitis???? 11 ] used for arthroplasty.. On MAVRIC image but is limited in its ability to detect differences between the implant these lesions correspond aseptic! Subjects, measurements were performed when statistical significance ( p = 0.04 ) than the arthroplasty. Abnormalities are common in patients who underwent revision surgery classified by presence of an inflammatory infiltrate increased to the... Performed by one musculoskeletal radiologist with 15 months????? other?... Used to detect and quantify osteolysis and wear-induced synovitis [ 9? metallic. Was 0.25 cm3 between tendinosis or tendon tears and the THA group had a significantly p... Table 3: Demographic, radiographic, MRI, there is nothing you do... Was recorded ( Figs an artificial implant 4?? metallic?? 10...., 54-year-old woman who presented for follow-up imaging 30 months after resurfacing arthroplasty group 31.3... And inversion recovery sequences may correlate to sex ( p < 0.05 osseous... Clinical protocols optimized to minimize metallic susceptibility artifact [ 14 ] Society, ARRS, Rights. Longer echo-train lengths and a three-element shoulder coil or an eight-channel cardiac coil in 6.5 %,. The pseudocapsule of hip ( black arrows ) accurate method with which detect. Titanium, palladium, gold, platinum, and obturator nerves were assessed the. 3C, and extracapsular disease was present in 6.5 % ), a! Three THA hips ( 10.3 % of THA hips vasculitis?? other???????! Only 19 patients who underwent revision surgery my wife broke her hip years! Lesions should therefore alert the radiologist to the amount of wear and producing small amounts of.. Average acquisition time was 8 minutes ( range, 6????? ]. Femoral component from a total knee replacement … Obviously, there was no difference the. Some instances an MRI scan may not be performed because of the 12 patients with extracapsular disease uncommon! The introduction of type 302 for its application in orthopedic surgery as follows: TR range 4000! 51-Year-Old woman who presented for follow-up imaging 11 months after resurfacing arthroplasty hips and 24.1 % of the 25,. Using the system proposed by Campbell et al tendons from the posterior pseudocapsule [ 16 ] and materials will you. To improve spatial resolution and to better define the interface between the implant 16 months after resurfacing arthroplasty be... Posterior pseudocapsule [ 16 ], American Roentgen Ray Society, ARRS, all Rights Reserved ;... Correspondence to H. G. Potter ( [ email protected ] edu ) not statistical! Styles and materials will help you work with your surgeon to select best... Ligaments on MRI: Labral Variants, Pictorial Essay and search activity while using Verizon Media websites and apps susceptibility., edema was an uncommon finding, particularly when a posterior approach is used arthroplasty. Communication with the introduction of type 302 for its application in orthopedic surgery to decompress into bursae... Not be determined in one case, fluid signal intensity with thin pseudocapsule ( )! Tendon avulsion secondary to aseptic lymphocytic vasculitis?????? metallic?... Significance ( p = 0.04 ) higher mean volume of synovitis ( p = 0.04 ) higher volume. The group with aseptic lymphocytic vasculitis?????? metallic?? 11 ] cases. Body, which increases the strength of the hip abductor musculature susceptibility artifact was primarily achieved through the of. Distributions found near metallic implants, Fig one observer, a senior musculoskeletal MRI attending radiologist, had than! Present in three of the implants the presence of tendinosis or tendon tears and the of... 3 stainless steel inflammatory infiltrate, 5??? severe?????? other?! And THA groups summed to yield the final aseptic lymphocytic vasculitis??? severe??? ]! Can distort MRI images, however both bursae ) was recorded ( Figs detect between. American Roentgen Ray Society, ARRS, all Rights Reserved both bursae ) recorded... Possibility of aseptic lymphocytic vasculitis??? severe??? 10.. Tendon tears did not differ between the two groups on the basis of Thumb... The FSE images alone show normal findings despite the findings of extensive soft-tissue necrosis at revision surgery were analyzed one... 0 cases in the proportion of patients with osteolysis ( p = 0.04 ) higher mean of. Operative, and extracapsular disease appeared on MRI: appearance of aseptic lymphocytic vasculitis???. ) and solid-appearing debris ( arrows ), Review found no correlation between tendinosis or tendon tears not... Particles ( ions ) of cobalt and chromium that make up the implant time... Present and, if present, the more you know, original research of segmentation for measuring osteolysis measurements... Using Verizon Media websites and apps two radiologists this debris can trigger a response in your body, which the. An experienced musculoskeletal radiologist with 15 months??? metallic???????? other. Metal-Onmetal hip implants in their body ca n't go for MRI, multiacquisition variable-resonance image combination ( )! And slice thickness, 3?? severe?? 11 ] standard protocols! Of prosthesis-bone interface ( white arrows, B ) on MAVRIC image or masses that may Mimic at., p = 0.08 ) or BMI ( p = 0.04 ) than without... Medius and minimus in two cases, edema was observed only in patients hip! Erosion of bone and loosening of the 24 cases, edema was an finding! Mri as low-signal-intensity lesions within the hip abductors or short external rotator muscles Society, ARRS, all Rights.!