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Prosthetic Joint Infection Diagnosis


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18F-fluoro-2-deoxyglucose Positron Emission Tomography/Computed Tomography Increased Activity Around the Bone-Prosthesis Interface

Slide 14

January 2010

Plain radiographs are inaccurate for diagnosis; periprosthetic radiolucency, osteolysis, and/or migration may be present in either prosthetic joint infection or aseptic loosening.  Computed tomography and magnetic resonance imaging are hampered by artifacts produced by the prostheses, although non-ferromagnetic (such as titanium or tantalum) implants are associated with minimal artifacts and provide good magnetic resonance imaging resolution for soft-tissue abnormalities.  Bone scans; including those performed as three-phase studies, are sensitive for detecting failed implants but cannot be used to determine the cause of failure, and may remain abnormal for more than a year after implantation.  Combined bone and gallium scans offer improvement over bone scan alone; however, labeled leukocyte imaging combined with bone scan has the best accuracy.



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