PMC5259669_01
Delayed-phase SPECT/CT displaying increased activity in the left AIIS extending to the superior acetabular rim.
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Interim bone scan (Figure 1) and MRI (Figure 2) showed a probable focus of osteomyelitis within the left anterior inferior iliac spine (AIIS) and small bilateral effusions concerning for superimposed septic arthritis.
T2 weighted MRI demonstrating a hyperintense focus in the left superior acetabular rim and hip effusion and capsular edema consistent with osteomyelitis and septic arthritis.
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Interim bone scan (Figure 1) and MRI (Figure 2) showed a probable focus of osteomyelitis within the left anterior inferior iliac spine (AIIS) and small bilateral effusions concerning for superimposed septic arthritis. Bone scintigraphy confirmed activity at the left AIIS (Figure 2).
Postoperative radiograph demonstrating first-stage cemented total hip replacement with 48/32 mm Stryker RimFit Acetabular cup and size 9 Biomet Simplex cement spacer.
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Palacos cement and similarly loaded cement spacer were implanted (Figure 3). Prior to home discharge with regular Voriconazole, the patient was mobilising with pain score of 0 on the left and minimal pain on the right side.
Plain radiograph showing progressive osteolysis of the superior right acetabular rim consistent with chronic infection.
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However, due to interval radiological changes (Figure 4) and right-sided pain at follow-up, a first-stage right hip arthroplasty was performed (Figure 5).
Postoperative radiograph demonstrating bilateral first-stage cemented total hip replacement.
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However, due to interval radiological changes (Figure 4) and right-sided pain at follow-up, a first-stage right hip arthroplasty was performed (Figure 5).