Non-invasive imaging methods in painful hip arthroplasties: Correlation of pain with radionuclide uptake and ultrasonography in conservatively managed patients

K. Foldes, K. Konrad, G. Bálint, I. Ratko, P. Bálint, W. W. Buchanan

Research output: Contribution to journalArticle

Abstract

The aim of our 1 year prospective study was to determine whether variation in clinical improvement in pain correlated with non-invasive imaging and whether such correlation changed after conservative therapy. A total of 34 replacement hip arthroplasties in 31 patients with pain following surgery were studied by plain film, radionuclide bone scan and ultrasonography. Changes in the different imaging methods and pain were compared after 1 year of conservative treatment. Twenty-two of the 34 painful arthroplasties had radiological evidence of loosening, either acetabular or femoral stem; 24 had positive bone scans, and 26 were positive by ultrasonography. A significant correlation was found between pain and isotopic findings (r = 0.3518, p <0.05, r = 0.3997, p <0.05) and pain and ultrasonography (r = 0.4270, p <0.05, r = 0.4276, p <0.05), but not plain radiographs, both before and after therapy. No significant correlation was found between bone scans and ultrasonographic findings at the start of the study, but there was after 1 year of conservative treatment in radiologically positive cases (r = 0.4580, p <0.05). All but two of those 14 hips with radiologically loosened acetabular components had ultrasonographic evidence of effusion and all but one had a positive bone scan. Bone scans and ultrasonography were positive in seven of 12 X-ray-negative hips. The results suggest that non-invasive imaging techniques including conventional plain radiographs, 99m-technetium bone scintigraphy and ultrasonography are complementary in the evaluation and monitoring of patients with painful hip arthroplasties.

Original languageEnglish
Pages (from-to)199-202
Number of pages4
JournalJournal of Orthopaedic Rheumatology
Volume8
Issue number4
Publication statusPublished - 1995

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Radioisotopes
Arthroplasty
Hip
Ultrasonography
Bone and Bones
Pain
Hip Replacement Arthroplasties
Technetium
Physiologic Monitoring
Motion Pictures
Thigh
Radionuclide Imaging
X-Rays
Prospective Studies
Conservative Treatment

Keywords

  • Conservative therapy
  • Non-invasive imaging
  • Painful hip arthroplasty

ASJC Scopus subject areas

  • Rheumatology
  • Surgery

Cite this

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title = "Non-invasive imaging methods in painful hip arthroplasties: Correlation of pain with radionuclide uptake and ultrasonography in conservatively managed patients",
abstract = "The aim of our 1 year prospective study was to determine whether variation in clinical improvement in pain correlated with non-invasive imaging and whether such correlation changed after conservative therapy. A total of 34 replacement hip arthroplasties in 31 patients with pain following surgery were studied by plain film, radionuclide bone scan and ultrasonography. Changes in the different imaging methods and pain were compared after 1 year of conservative treatment. Twenty-two of the 34 painful arthroplasties had radiological evidence of loosening, either acetabular or femoral stem; 24 had positive bone scans, and 26 were positive by ultrasonography. A significant correlation was found between pain and isotopic findings (r = 0.3518, p <0.05, r = 0.3997, p <0.05) and pain and ultrasonography (r = 0.4270, p <0.05, r = 0.4276, p <0.05), but not plain radiographs, both before and after therapy. No significant correlation was found between bone scans and ultrasonographic findings at the start of the study, but there was after 1 year of conservative treatment in radiologically positive cases (r = 0.4580, p <0.05). All but two of those 14 hips with radiologically loosened acetabular components had ultrasonographic evidence of effusion and all but one had a positive bone scan. Bone scans and ultrasonography were positive in seven of 12 X-ray-negative hips. The results suggest that non-invasive imaging techniques including conventional plain radiographs, 99m-technetium bone scintigraphy and ultrasonography are complementary in the evaluation and monitoring of patients with painful hip arthroplasties.",
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T2 - Correlation of pain with radionuclide uptake and ultrasonography in conservatively managed patients

AU - Foldes, K.

AU - Konrad, K.

AU - Bálint, G.

AU - Ratko, I.

AU - Bálint, P.

AU - Buchanan, W. W.

PY - 1995

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N2 - The aim of our 1 year prospective study was to determine whether variation in clinical improvement in pain correlated with non-invasive imaging and whether such correlation changed after conservative therapy. A total of 34 replacement hip arthroplasties in 31 patients with pain following surgery were studied by plain film, radionuclide bone scan and ultrasonography. Changes in the different imaging methods and pain were compared after 1 year of conservative treatment. Twenty-two of the 34 painful arthroplasties had radiological evidence of loosening, either acetabular or femoral stem; 24 had positive bone scans, and 26 were positive by ultrasonography. A significant correlation was found between pain and isotopic findings (r = 0.3518, p <0.05, r = 0.3997, p <0.05) and pain and ultrasonography (r = 0.4270, p <0.05, r = 0.4276, p <0.05), but not plain radiographs, both before and after therapy. No significant correlation was found between bone scans and ultrasonographic findings at the start of the study, but there was after 1 year of conservative treatment in radiologically positive cases (r = 0.4580, p <0.05). All but two of those 14 hips with radiologically loosened acetabular components had ultrasonographic evidence of effusion and all but one had a positive bone scan. Bone scans and ultrasonography were positive in seven of 12 X-ray-negative hips. The results suggest that non-invasive imaging techniques including conventional plain radiographs, 99m-technetium bone scintigraphy and ultrasonography are complementary in the evaluation and monitoring of patients with painful hip arthroplasties.

AB - The aim of our 1 year prospective study was to determine whether variation in clinical improvement in pain correlated with non-invasive imaging and whether such correlation changed after conservative therapy. A total of 34 replacement hip arthroplasties in 31 patients with pain following surgery were studied by plain film, radionuclide bone scan and ultrasonography. Changes in the different imaging methods and pain were compared after 1 year of conservative treatment. Twenty-two of the 34 painful arthroplasties had radiological evidence of loosening, either acetabular or femoral stem; 24 had positive bone scans, and 26 were positive by ultrasonography. A significant correlation was found between pain and isotopic findings (r = 0.3518, p <0.05, r = 0.3997, p <0.05) and pain and ultrasonography (r = 0.4270, p <0.05, r = 0.4276, p <0.05), but not plain radiographs, both before and after therapy. No significant correlation was found between bone scans and ultrasonographic findings at the start of the study, but there was after 1 year of conservative treatment in radiologically positive cases (r = 0.4580, p <0.05). All but two of those 14 hips with radiologically loosened acetabular components had ultrasonographic evidence of effusion and all but one had a positive bone scan. Bone scans and ultrasonography were positive in seven of 12 X-ray-negative hips. The results suggest that non-invasive imaging techniques including conventional plain radiographs, 99m-technetium bone scintigraphy and ultrasonography are complementary in the evaluation and monitoring of patients with painful hip arthroplasties.

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