There is no relevant literature documenting additional benefit of CT with IV contrast, relative to noncontrast CT for fracture detection/assessment. Contrast may be helpful if there is a question of vascular injury [23]. The reported efficacy of CT to provide information regarding component loosening (for treatment planning) when a fracture is present is inconsistent [68,71]. Case reports suggest CT to be more sensitive than radiographs for detecting fracture of a ceramic liner [53]. FDG-PET/CT Skull Base to Mid-Thigh There is insufficient evidence to support the use of FDG-PET/CT skull base to mid-thigh in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. Imaging After Total Hip Arthroplasty Fluoride PET/CT Skull Base To Mid-Thigh There is insufficient evidence to support the use of fluoride PET/CT skull base to mid-thigh in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. Image-Guided Aspiration Hip There is insufficient evidence to support the use of image-guided aspiration of the hip in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. MRI Hip MRI can demonstrate femoral periprosthetic fractures and stress reactions [18]. However, a nondisplaced fracture may be difficult to see on MRI if there is only mild associated marrow edema, and susceptibility artifact from the prosthesis may obscure the pertinent findings [72]. Pelvic fractures can be demonstrated. There is no relevant literature documenting the additional benefit of MRI with IV contrast, relative to noncontrast MRI, for fracture detection. US Hip US is limited in its ability to detect periprosthetic fracture [73]. WBC Scan and Sulfur Colloid Scan Hip There is insufficient evidence to support the use of white blood cell (WBC) and sulfur colloid of the hip imaging in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. Variant 4: Symptomatic hip arthroplasty patient, infection not excluded.
Imaging after Total Hip Arthroplasty PCAs. There is no relevant literature documenting additional benefit of CT with IV contrast, relative to noncontrast CT for fracture detection/assessment. Contrast may be helpful if there is a question of vascular injury [23]. The reported efficacy of CT to provide information regarding component loosening (for treatment planning) when a fracture is present is inconsistent [68,71]. Case reports suggest CT to be more sensitive than radiographs for detecting fracture of a ceramic liner [53]. FDG-PET/CT Skull Base to Mid-Thigh There is insufficient evidence to support the use of FDG-PET/CT skull base to mid-thigh in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. Imaging After Total Hip Arthroplasty Fluoride PET/CT Skull Base To Mid-Thigh There is insufficient evidence to support the use of fluoride PET/CT skull base to mid-thigh in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. Image-Guided Aspiration Hip There is insufficient evidence to support the use of image-guided aspiration of the hip in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. MRI Hip MRI can demonstrate femoral periprosthetic fractures and stress reactions [18]. However, a nondisplaced fracture may be difficult to see on MRI if there is only mild associated marrow edema, and susceptibility artifact from the prosthesis may obscure the pertinent findings [72]. Pelvic fractures can be demonstrated. There is no relevant literature documenting the additional benefit of MRI with IV contrast, relative to noncontrast MRI, for fracture detection. US Hip US is limited in its ability to detect periprosthetic fracture [73]. WBC Scan and Sulfur Colloid Scan Hip There is insufficient evidence to support the use of white blood cell (WBC) and sulfur colloid of the hip imaging in the evaluation of the symptomatic hip prosthesis in the setting of acute injury. Variant 4: Symptomatic hip arthroplasty patient, infection not excluded.