Fluoride PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of fluoride PET/CT skull base to mid-thigh in the follow-up of the asymptomatic patient with a primary shoulder arthroplasty. MRI Shoulder MRI examinations are not typically ordered for evaluation of the asymptomatic patient. Radiographs are also typically ordered for yearly follow-up examinations to assess interval changes in the bone surrounding the prosthesis [16]. The presence of scapular notching on postoperative radiographs of reverse total shoulder prostheses has been associated with poor clinical outcomes [17]. The risk for loosening increases over time, with notable radiographic changes associated with loosening found at least 5 years after surgery, most commonly involving the glenoid component [18]. Late complications requiring revision surgery, such as loosening, infection, and fracture, occurring up to 15 years postoperatively, suggests the need for long-term radiographic follow-up when these complications are asymptomatic or their outcome can be affected by early detection on radiographs [10]. US Shoulder US examinations are not typically ordered for evaluation of the asymptomatic patient. 3-Phase Bone Scan with SPECT or SPECT/CT Shoulder There is no relevant literature to support the use of a 3-phase bone scan with SPECT or SPECT/CT as a first-line imaging modality in the acutely symptomatic patient with a primary shoulder arthroplasty. Similar to bone scans, a 3-phase bone scan is highly sensitive for the detection of periprosthetic fractures but suffers from low specificity. Imaging After Shoulder Arthroplasty Acute periprosthetic fractures are often 3-phase bone scan positive and demonstrate focal increased activity at the fracture site, which decreases over time, corresponding to fracture healing. Fracture hyperemia also typically resolves with the acute/subacute phases.
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 skull base to mid-thigh in the follow-up of the asymptomatic patient with a primary shoulder arthroplasty. MRI Shoulder MRI examinations are not typically ordered for evaluation of the asymptomatic patient. Radiographs are also typically ordered for yearly follow-up examinations to assess interval changes in the bone surrounding the prosthesis [16]. The presence of scapular notching on postoperative radiographs of reverse total shoulder prostheses has been associated with poor clinical outcomes [17]. The risk for loosening increases over time, with notable radiographic changes associated with loosening found at least 5 years after surgery, most commonly involving the glenoid component [18]. Late complications requiring revision surgery, such as loosening, infection, and fracture, occurring up to 15 years postoperatively, suggests the need for long-term radiographic follow-up when these complications are asymptomatic or their outcome can be affected by early detection on radiographs [10]. US Shoulder US examinations are not typically ordered for evaluation of the asymptomatic patient. 3-Phase Bone Scan with SPECT or SPECT/CT Shoulder There is no relevant literature to support the use of a 3-phase bone scan with SPECT or SPECT/CT as a first-line imaging modality in the acutely symptomatic patient with a primary shoulder arthroplasty. Similar to bone scans, a 3-phase bone scan is highly sensitive for the detection of periprosthetic fractures but suffers from low specificity. Imaging After Shoulder Arthroplasty Acute periprosthetic fractures are often 3-phase bone scan positive and demonstrate focal increased activity at the fracture site, which decreases over time, corresponding to fracture healing. Fracture hyperemia also typically resolves with the acute/subacute phases.