Analysis of 18F-FDG uptake patterns in PET for diagnosis of septic and aseptic loosening after total hip arthroplasty

2003 ◽  
Vol 42 (06) ◽  
pp. 234-239 ◽  
Author(s):  
T. Mumme ◽  
P. Reinartz ◽  
D. Wirtz ◽  
F. U. Niethard ◽  
U. Büll ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Femoral Component ◽  
Hip Prosthesis ◽  
Prosthetic Infection ◽  
Clinical Value ◽  
Septic Loosening ◽  
Hip Prostheses ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Painful Hip

Summary Aim: Identification of typical patterns for fluorodeoxyglucose (FDG) uptake in positron emission tomography (PET) to detect aseptic loosening of hip prosthesis (ace-tabular and/or femoral component) and prosthetic infection. Methods: 18 patients with painful hip prosthesis underwent PET using a dedicated full ring scanner after application of 200-300 MBq FDG. The interface between bone and surrounding soft tissue or bone as displayed on coronal slices was divided into 12 segments in accordance with the classifications of Delee and Gruen. FDG uptake in each of the segments was scored (0-3) by two independent observers. Intraoperative findings were regarded as the gold standard. Results: After surgical revision 14 acetabular components and 9 femoral components were found to be loose and prosthetic infection was present in 7 prostheses. Loosening of the acetabular component was correlated to enhanced uptake in the middle of the acetabular interface, while loosening of the femoral component was correlated to enhanced uptake in the proximal and middle segment of the lateral femoral interface and the proximal segment of the medial femoral interface. A similar pattern was found in prosthetic infection with high uptake along the middle portion of the lateral fe-moral interface. In 6 of 7 infected prostheses loosening of the acetabular and of the femoral component was present. Taking the typical uptake patterns as criteria for loosening and grade 3 uptake as an additional criterion for septic loosening the accuracy of PET imaging in the detection of loosening of the acetabular or the femoral component and of prosthetic infection was 72, 78 and 89%, respectively. Conclusion: This pilot study presents FDG-PET as a promising diagnostic tool for patients with painful hip prostheses. Its clinical value should be evaluated in a larger patient population.

Femoral Anteversion and Restricted Range of Motion in Total Hip Prostheses

1988 ◽  
Vol 29 (5) ◽  
pp. 551-553 ◽  
Author(s):  
K. Herrlin ◽  
H. Pettersson ◽  
G. Selvik ◽  
L. Lidgren
Keyword(s):  
Range Of Motion ◽  
Femoral Component ◽  
Hip Prosthesis ◽  
Femoral Anteversion ◽  
Restricted Range ◽  
Total Hip Prosthesis ◽  
Hip Prostheses ◽  
Total Hip ◽  
Total Hip Prostheses

Impingement of the neck of the stem on to the rim of the socket may cause dislocation of the total hip prosthesis. The role of femoral anteversion in the occurrence of such impingement was analyzed in a clinical material of total hip prostheses with and without dislocation. A low femoral anteversion was linked to a clinically relevant reduction of the range of motion due to impingement and dominated in the group with dislocations. Impingement is minimized by inserting the femoral component in 10° to 20° of anteversion.

3rd Generation Alumina-on-Alumina in Modular Hip Prosthesis: 13 to 18 Years Follow-up Results

2016 ◽  
Vol 27 (1) ◽  
pp. 8-13 ◽  
Author(s):  
Aldo Toni ◽  
Federico Giardina ◽  
Giovanni Guerra ◽  
Alessandra Sudanese ◽  
Maurizio Montalti ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Hip Prosthesis ◽  
Septic Loosening ◽  
Early Experiences ◽  
Clinical And Radiological Outcome ◽  
The Mean ◽  
Modular Hip Prosthesis ◽  
Ceramic On Ceramic

Introduction Ceramic-on-ceramic (CoC) couplings are alternative bearings surfaces that have been reported to reduce osteolysis, wear debris and aseptic loosening compared to the use of polyethylene. Early experiences with ceramics had poor results, but they have led to many improvements in the manufacture and design of subsequent implants. Methods We analysed medical files of 300 CoC total hip arthroplasty (THA) with a modular neck performed during period 1995-2000 by a single surgeon for a minimum follow-up of 13 years, evaluating clinical and radiological outcome. Results The mean clinical Merle d'Aubigne and Postel hip score at the final follow-up is 17.4, against a pre-operative value of 11.4. Overall survivorship with an endpoint of revision is 93.2% (95% CI, 89.0%-97.3%) at 15 years, while considering only prosthesis failures related to aseptic loosening and ceramic breakage, survival rate at 15 years is 97.2% (95% CI, 94.8%-100%). We observed complications that led to revision surgery in 11 patients (4%) (periprosthetic fractures, liner ruptures, septic loosening of the implant, aseptic loosening of the cup, aseptic loosening of the stem). The occurrence of squeaking is low (1.6%, 4 cases) and we analysed the characteristics of these patients. Discussion Our study shows an excellent long term survivorship of third generation alumina CoC THA. We reiterate the importance to have a stable implant to maximise the advantage of ceramic and to avoid complications.

scholarly journals Common features of F-18 FDG PET/CT findings in Scrub Typhus: prospective study before and after antibiotics therapy

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Joo-Hee Hwang ◽  
Yeon-Hee Han ◽  
Seung Hee Choi ◽  
Mir Jeon ◽  
Suhyun Kim ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Clinical Value ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Before And After ◽  
Generalized Lymphadenopathy ◽  
Fdg Pet Ct

Abstract Scrub typhus is an acute febrile illness caused by obligate intracellular organism Orientia tsutsugamushi. While there have been many reports on the evaluation of disease activity and infectious diseases using F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), the clinical value of FDG PET/CT in scrub typhus has not been fully investigated. We enrolled 17 patients who were 18 years of age or older and clinically suspected of having scrub typhus with eschar. Clinical assessments, blood samples, and FDG PET/CT images were obtained at enrolment and again after 3 weeks. The median age of the patients was 65 years; 9 (52.9%) patients were male. On initial FDG PET/CT, the eschars showed markedly increased FDG uptake on PET imaging that improved after treatment. Generalized lymphadenopathy and splenomegaly with high FDG uptake were observed in all patients. On follow-up FDG PET/CT after appropriate therapy, FDG uptake and sizes of eschar, lymph nodes, and spleen were markedly decreased. As far as we are aware, this is the first investigation with multiple patients of FDG PET/CT in scrub typhus and the demonstration of clinical utility. FDG PET/CT imaging of scrub typhus could provide useful information about the clinical features before and after antibiotic treatment.

Accuracy of diagnostic imaging techniques in the diagnosis of aseptic loosening of the femoral component of a hip prosthesis

2005 ◽  
Vol 87-B (6) ◽  
pp. 781-785 ◽  
Author(s):  
O. P. P. Temmerman ◽  
P. G. H. M. Raijmakers ◽  
J. Berkhof ◽  
O. S. Hoekstra ◽  
G. J. J. Teule ◽  
...  
Keyword(s):  
Diagnostic Imaging ◽  
Aseptic Loosening ◽  
Femoral Component ◽  
Hip Prosthesis ◽  
Imaging Techniques ◽  
Diagnostic Imaging Techniques

99mTc-labeled ubiquicidin scintigraphy

2012 ◽  
Vol 51 (04) ◽  
pp. 133-139 ◽  
Author(s):  
K. Aryana ◽  
A. Hootkani ◽  
R. Sadeghi ◽  
Y. Davoudi ◽  
M. Naderinasab ◽  
...  
Keyword(s):  
Bone Scan ◽  
Hip Prosthesis ◽  
High Sensitivity ◽  
Final Diagnosis ◽  
Predictive Values ◽  
Bacterial Colony ◽  
Hip Prostheses ◽  
Hip Prosthesis Implantation ◽  
Sensitivity Specificity ◽  
Painful Hip

SummaryAim: Hip prosthesis implantation has witnessed a significant increase in recent years. Despite the advantages of this surgical procedure, it has some complications, the most serious of which is prosthetic infection. This study was conducted to investigate the feasibility of 99mTc-UBI scintigraphy in detection of infectious foci in painful hip prosthesis. UBI (Ubiquicidin 29–41) is an antimicrobial peptide fragment with the ability to target the bacterial colony directly. Patients, methods: 34 patients, aged 20–79 years, with painful hip prosthesis were included. 99mTc-UBI scan and three phase bone scan were performed and two nuclear medicine specialists interpreted the UBI scans with and without bone scan results at hand. Both qualitative and semiquantitative methods were used to interpret the 30 minute post injection images. The patients were actively followed up. According to the surgical findings, microbiological culture and active follow up, final diagnosis was made. Results: 24 negative and 10 positive UBI scans were recorded. The sensitivity, specificity, negative and positive predictive values and accuracy of the study were all 100%. Bone scan did not have any influence on UBI interpretation. We were able to achieve excellent differentiation between infected and non-infected prostheses with a cut off value of 1.8 for target to non target (T/NT) ratio. No adverse effects were noticed following UBI scan. Conclusion: Based on the findings, the authors believe that 99mTc-UBI scintigraphy, with its high sensitivity and specificity, provides the physician with an excellent tool for differentiating infection from aseptic loosening of hip prostheses. Using this radiopharmaceutical, it is possible to obtain highly accurate results only 30 minutes after the beginning of the study.

Novel methods for demonstrating osseointegration of hydroxylapatite-coated titanium hip prostheses

1991 ◽  
Vol 49 ◽  
pp. 34-35 ◽  
Author(s):  
P. Frayssinet ◽  
J. Hanker ◽  
D. Hardy ◽  
B. Giammara
Keyword(s):  
Hip Prosthesis ◽  
Ethanol Concentration ◽  
Bone Matrix ◽  
Electron Microscopic Examination ◽  
Electron Microscopic ◽  
Hip Prostheses ◽  
Cellular Inclusions ◽  
Microscopic Studies ◽  
Diamond Saw ◽  
Plasma Sprayed

Prostheses implanted in hard tissues cannot be processed for electron microscopic examination or microanalysis in the same way as those in other tissues. For these reasons, we have developed methods allowing light and electron microscopic studies as well as microanalysis of the interface between bone and a metal biomaterial coated by plasma-sprayed hydroxylapatite(HA) ceramic.An HA-coated titanium hip prosthesis (Corail, Landos, France), which had been implanted for two years, was removed after death (unrelated to the orthopaedic problem). After fixation it was dehydrated in solutions of increasing ethanol concentration prior to embedment in polymethylmethacrylate(PMMA). Transverse femur sections were obtained with a diamond saw and the sections then carefully ground to a thickness of 200 microns. Plastic-embedded sections were stained for calcium with a silver methenamine modification of the von Kossa method for calcium staining and coated by carbon. They have been examined by back-scatter SEM on an ISI-SS60 operated at 25 KV. EDAX has been done on cellular inclusions and extracellular bone matrix.

scholarly journals Characteristics and Clinical Value of 18F-FDG PET/CT in the Management of Adult-Onset Still’s Disease: 35 Cases

2021 ◽  
Vol 10 (11) ◽  
pp. 2489
Author(s):  
Josselin Brisset ◽  
Yvan Jamilloux ◽  
Stephanie Dumonteil ◽  
Guillaume Lades ◽  
Martin Killian ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Lymph Node ◽  
Differential Diagnoses ◽  
Adult Onset Still’S Disease ◽  
Still’S Disease ◽  
Clinical Value ◽  
Fdg Uptake ◽  
Pet Ct ◽  
18F Fdg ◽  
Adult Onset Still's Disease

While the diagnosis of adult-onset Still’s disease (AOSD) involves the exclusion of differential diagnoses, the characteristics and value of 18F-Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography coupled with CT (PET/CT) in the management of AOSD remain poorly known. Our retrospective study included patients from four centers, fulfilling Yamaguchi or Fautrel criteria, who underwent a PET/CT during an active AOSD. Thirty-five patients were included. At the time of PET/CT, the Yamaguchi criteria were met in 23 of 29 evaluable cases. PET/CT showed bone marrow (74.3%), lymph node (74.3%), and splenic (48.6%) FDG uptake. Despite arthralgia or arthritis in most patients, joints were rarely the sites of 18F-FDG accumulation. The spatial distribution of 18F-FDG uptake was nonspecific, and its intensity could be similar to malignant disease. Lymph node or bone marrow biopsy was performed after PET/CT in 20 patients (57.1%). The intensity of bone marrow; splenic and lymph node hypermetabolism appeared to be correlated with disease activity. Abnormal PET/CT in the cervical lymph nodes and age ≥ 60 years seemed to be predictive factors for monocyclic evolution. The clinical value of PET/CT is not in direct diagnosis; but as an aid in excluding differential diagnoses by searching for their scintigraphic features and guiding biopsy.

Sign in / Sign up

Export Citation Format

Share Document