Comparison with operatively identified pseudotumors showed US to have a sensitivity of 90.9% and a specificity of 42.9% compared with an MRI sensitivity of 93.9% and a specificity 57.1%. The PPV was similar (88.2% US, 91.2% MRI) but the NPV was higher for MRI (66.7% on MRI, 50.0% for US) [66]. Variant 3: Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs. If a fracture is suspected clinically but is not demonstrated or not fully characterized on radiographs, additional imaging may be necessary. Fracture location, component stability (stable versus loose), and femoral bone stock are features that can influence management and that can be assessed on imaging [67-70]. Bone Scan and Gallium Scan Hip There is insufficient evidence to support the use of combined bone and gallium scan of the hip in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. Bone Scan and Gallium Scan With SPECT or SPECT/CT Hip There is insufficient evidence to support the use of combined bone and gallium scan with SPECT or SPECT/CT hip in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. Bone Scan Hip There is insufficient evidence to support the use of the bone scan of the hip in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. Bone Scan with SPECT or SPECT/CT Hip There is insufficient evidence to support the use of the bone scan with SPECT or SPECT/CT of the hip in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. CT Hip Nonenhanced multidetector CT of the hip has been suggested for fracture detection when radiographs are negative or equivocal and there is high suspicion for periprosthetic fracture or when additional fracture characterization is needed for treatment planning [22,70].
Imaging after Total Hip Arthroplasty PCAs. Comparison with operatively identified pseudotumors showed US to have a sensitivity of 90.9% and a specificity of 42.9% compared with an MRI sensitivity of 93.9% and a specificity 57.1%. The PPV was similar (88.2% US, 91.2% MRI) but the NPV was higher for MRI (66.7% on MRI, 50.0% for US) [66]. Variant 3: Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs. If a fracture is suspected clinically but is not demonstrated or not fully characterized on radiographs, additional imaging may be necessary. Fracture location, component stability (stable versus loose), and femoral bone stock are features that can influence management and that can be assessed on imaging [67-70]. Bone Scan and Gallium Scan Hip There is insufficient evidence to support the use of combined bone and gallium scan of the hip in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. Bone Scan and Gallium Scan With SPECT or SPECT/CT Hip There is insufficient evidence to support the use of combined bone and gallium scan with SPECT or SPECT/CT hip in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. Bone Scan Hip There is insufficient evidence to support the use of the bone scan of the hip in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. Bone Scan with SPECT or SPECT/CT Hip There is insufficient evidence to support the use of the bone scan with SPECT or SPECT/CT of the hip in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. CT Hip Nonenhanced multidetector CT of the hip has been suggested for fracture detection when radiographs are negative or equivocal and there is high suspicion for periprosthetic fracture or when additional fracture characterization is needed for treatment planning [22,70].