Fluoride PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of fluoride PET/CT for the next imaging study of a symptomatic patient with a primary shoulder arthroplasty when infection has been not excluded. MRI Shoulder MRI with metal reduction protocols can play a useful role in the diagnosis [37,38] and assessment of periprosthetic infection, particularly when other modalities fail to confirm the clinical suspicion of infection. MRI can demonstrate osseous and soft-tissue abnormalities associated with periprosthetic infection [28,39]. MRI can depict marrow edema suggestive of osteomyelitis. It can depict bony destruction, which can be difficult to note on radiographs, Imaging After Shoulder Arthroplasty related to osteomyelitis. MRI can also demonstrate joint effusions, adjacent soft-tissue edema, and fluid loculations suggestive of abscesses. Administration of IV contrast improves the evaluation of adjacent soft-tissue fluid collections/abscesses and sinus tracts. US Shoulder US examinations are increasingly being ordered for evaluation of periprosthetic infection in the setting of shoulder arthroplasty to evaluate for joint effusion and surrounding soft-tissue infection. US may be of use for the evaluation of a joint effusion, bursal distention, and the surrounding soft-tissues for signs of infection including abscesses [40- 42], which need aspiration and testing to determine the presence of infection and identification of the underlying microorganism. US is useful to evaluate the surrounding soft tissues for infection and to aid in planning before image-guided joint aspiration in order to avoid seeding of a sterile joint effusion from overlying soft-tissue infection. WBC Scan and Sulfur Colloid Scan Shoulder For infection imaging, In-111 WBC imaging in conjunction with Tc-99m sulfur colloid marrow imaging is a sensitive and specific test.
Imaging After Shoulder Arthroplasty PCAs. Fluoride PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of fluoride PET/CT for the next imaging study of a symptomatic patient with a primary shoulder arthroplasty when infection has been not excluded. MRI Shoulder MRI with metal reduction protocols can play a useful role in the diagnosis [37,38] and assessment of periprosthetic infection, particularly when other modalities fail to confirm the clinical suspicion of infection. MRI can demonstrate osseous and soft-tissue abnormalities associated with periprosthetic infection [28,39]. MRI can depict marrow edema suggestive of osteomyelitis. It can depict bony destruction, which can be difficult to note on radiographs, Imaging After Shoulder Arthroplasty related to osteomyelitis. MRI can also demonstrate joint effusions, adjacent soft-tissue edema, and fluid loculations suggestive of abscesses. Administration of IV contrast improves the evaluation of adjacent soft-tissue fluid collections/abscesses and sinus tracts. US Shoulder US examinations are increasingly being ordered for evaluation of periprosthetic infection in the setting of shoulder arthroplasty to evaluate for joint effusion and surrounding soft-tissue infection. US may be of use for the evaluation of a joint effusion, bursal distention, and the surrounding soft-tissues for signs of infection including abscesses [40- 42], which need aspiration and testing to determine the presence of infection and identification of the underlying microorganism. US is useful to evaluate the surrounding soft tissues for infection and to aid in planning before image-guided joint aspiration in order to avoid seeding of a sterile joint effusion from overlying soft-tissue infection. WBC Scan and Sulfur Colloid Scan Shoulder For infection imaging, In-111 WBC imaging in conjunction with Tc-99m sulfur colloid marrow imaging is a sensitive and specific test.