Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Imaging After Shoulder Arthroplasty surrounding osseous and soft-tissue structures. The selection of the next imaging modality depends on several factors, including findings on the initial imaging study, clinical suspicion of an osseous versus soft-tissue injury, or clinical suspicion of infection. Special Imaging Considerations Arthrography Arthrography, using only radiographic or fluoroscopic images, had previously been utilized for detecting rotator cuff tears in the setting of shoulder arthroplasty. Because of its inability to assess muscle quality, gradation of partial tearing, and differentiate between the torn rotator cuff tendons, conventional radiographic arthrography has mostly been supplanted by cross-sectional imaging techniques such as CT arthrography, MR arthrography, and ultrasound (US). Nuclear Medicine The use of nuclear medicine in the evaluation of complications after arthroplasty has been limited to the evaluation of hip and knee arthroplasties. Because of limited literature on shoulder arthroplasties, these same physiologic principles can be applied to shoulder arthroplasties, and radionuclide imaging is not limited by metallic hardware [11]. Tc-99m-methylene diphosphonate (MDP) bone scans are useful in assessing shoulder arthroplasties, especially with normal radiographs and persistent concern for aseptic loosening, osteomyelitis, or periprosthetic fractures. Unfortunately, the specificity of bone scans is low, and new bone formation can also be seen in normal or abnormal postoperative bony remodeling and neuropathic arthropathy in addition to acute fractures, periprosthetic infection, or aseptic prosthetic loosening. Typical bone scans are either a single or a 3-phase study.
Imaging After Shoulder Arthroplasty PCAs. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Imaging After Shoulder Arthroplasty surrounding osseous and soft-tissue structures. The selection of the next imaging modality depends on several factors, including findings on the initial imaging study, clinical suspicion of an osseous versus soft-tissue injury, or clinical suspicion of infection. Special Imaging Considerations Arthrography Arthrography, using only radiographic or fluoroscopic images, had previously been utilized for detecting rotator cuff tears in the setting of shoulder arthroplasty. Because of its inability to assess muscle quality, gradation of partial tearing, and differentiate between the torn rotator cuff tendons, conventional radiographic arthrography has mostly been supplanted by cross-sectional imaging techniques such as CT arthrography, MR arthrography, and ultrasound (US). Nuclear Medicine The use of nuclear medicine in the evaluation of complications after arthroplasty has been limited to the evaluation of hip and knee arthroplasties. Because of limited literature on shoulder arthroplasties, these same physiologic principles can be applied to shoulder arthroplasties, and radionuclide imaging is not limited by metallic hardware [11]. Tc-99m-methylene diphosphonate (MDP) bone scans are useful in assessing shoulder arthroplasties, especially with normal radiographs and persistent concern for aseptic loosening, osteomyelitis, or periprosthetic fractures. Unfortunately, the specificity of bone scans is low, and new bone formation can also be seen in normal or abnormal postoperative bony remodeling and neuropathic arthropathy in addition to acute fractures, periprosthetic infection, or aseptic prosthetic loosening. Typical bone scans are either a single or a 3-phase study.