Diagnostic accuracy and interobserver variability of plain radiography, subtraction arthrography, nuclear arthrography, and bone scintigraphy in the assessment of aseptic femoral component loosening.

Background: Plain radiography, subtraction arthrography, nuclear arthrography, and bone scintigraphy are imaging techniques commonly used to identify aseptic femoral component loosening. Controversy exists about the relative utility of these techniques.

Patients And Methods: We evaluated the diagnostic accuracy and interobserver reliability of the four techniques in 78 consecutive patients (mean age 70 years, range 29-88 years) referred for evaluation of their femoral hip prostheses.

A comparison of radiographic and scintigraphic techniques to assess aseptic loosening of the acetabular component in a total hip replacement.

Background: The diagnosis of a loose total hip prosthesis is often established with use of radiographic and nuclear medicine techniques, but there is controversy about the relative utility of plain radiography, subtraction arthrography, nuclear arthrography, and bone scintigraphy. In this retrospective study, we evaluated the sensitivity, specificity, and interobserver reliability of these imaging modalities in patients suspected of having aseptic loosening of the acetabular component.

Methods: From 1994 to 1999, eighty-six consecutive patients with pain after a total hip arthroplasty were evaluated for possible loosening of the components.