PMC4898222_01
50-year-old man with extensive metallosis. Judet view of the pelvis shows bilateral total hip arthroplasties. There is osteolysis of the right greater and lesser trochanters and acetabulum. Also seen are fractures of the right superior and inferior pubic rami.
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There were also fractures of the greater trochanter, lesser trochanter, and right superior and inferior pubic rami (Fig. 1).
50-year-old man with extensive metallosis. Axial CT of the pelvis in bone windows shows osteolysis of the right acetabulum with foci of small metallic debris. The medial acetabular wall is completely destroyed.
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CT of the pelvis further demonstrated the extent of the osteolysis and fractures. CT also showed non-x-ray-apparent fluid-attenuation collections with high-density-material rims along the synovial margins of the right hip joint (Figure 2, Figure 3).
50-year-old man with extensive metallosis. Noncontrast CT of the right hip joint, at the level of the inferior pubic ramus, shows several round, fluid-density collections with high-density peripheral rims, which are located both anterolaterally and posteromedially along the capsule of the right hip joint. Artifact from right hip prostheses is also present.
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CT of the pelvis further demonstrated the extent of the osteolysis and fractures. CT also showed non-x-ray-apparent fluid-attenuation collections with high-density-material rims along the synovial margins of the right hip joint (Figure 2, Figure 3).
50-year-old man with extensive metallosis. Radiogaph of the right hip shows further osteolysis of the greater and lesser trochanters and right acetabulum. A new fracture of the superior acetabular wall is present with superior migration of the femur. Small metallic particles are now seen on radiographs surrounding the hip prosthesis.
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Radiographs and noncontrast CT of the pelvis revealed a new fracture of the right acetabulum with significant superior subluxation of the hip and extensive surrounding osteolysis (Fig. 4).
50-year-old man with extensive metallosis. Coronal reformatted CT of the pelvis without contrast in bone algorithm shows complete osteolysis of the right acetabulum with the space replaced by soft-tissue density and multiple foci of metallic debris, suggestive of advanced metallosis. The right femur is superiorly subluxated.
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Findings were consistent with advanced metallosis (Figure 5, Figure 6, Figure 7A, Figure 7B, Figure 7C).
50-year-old man with extensive metallosis. Axial image from noncontrast CT of the pelvis shows more round, fluid-density lesions with metallic-density peripheral rims. The lesions are anteromedial and posterolateral to the prosthesis, along the hip joint capsule.
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Findings were consistent with advanced metallosis (Figure 5, Figure 6, Figure 7A, Figure 7B, Figure 7C).
Volume-rendered 3D reformation of CT of prostheses. Medial surface of left acetabular component.
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Findings were consistent with advanced metallosis (Figure 5, Figure 6, Figure 7A, Figure 7B, Figure 7C).