1. Imaging plays an important role in aiding of the diagnosis of early implant failure and soft-tissue complications.
2. The authors are unaware of any published literature quoting the sensitivity and specificity of the different modalities in relation to the diagnosis of adverse metal reactions and implant failure.
[added by Connie-I think Hollis Potter MD-Hospital of Special Services has a number of videos on the merits of using MARS MRIs over other methods as a diagnostic aid that is far superior- with the right protocol-to other methods mentioned here. In fact, the two videos which I have blogged and summarized are two of the highest trafficked blogs on this site. Type in Hollis Potter in the blog landing page search box or you can go to: Using MRI’s with an optimized protocol to detect metal debris by Hollis Potter MD http://accordent02.origindigital.net/dmn/NOV18MARS_Archive/main.htm ]
3. All modalities mentioned above can be used to add value. It is a function of what you are trying to discover.
4. Plain radiographs (xrays) may be used to define the position of the implant.
- low radiation
- high availability of the xray
- can't see soft tissue damage
- validity of a plain radiograph may be compromised by the large metal heads because the acetabular rim is obscured.
- [Added by Connie as the disadvantages aren't listed-radiation exposure is higher in CT scans. Radiation levels are higher with CTs.]
7. Ultrasound may be useful when small underlying soft tissue lesions are suspected.