PMC4895867_01
85-year-old female with metallosis of left total hip replacement. Anterior and posterior projections of a bone scintigraphy study using 30mCi IV technetium-99m-labeled methylene diphosphonate (Tc-MDP) in the 15-minute blood pooling and 3.0-hour delay phases were obtained. This scan demonstrates presence of bilateral THRs with significant increased uptake of Tc-MDP in the periprosthetic bony and soft tissues of the left hip joint in the blood pooling phase (arrows). Delayed phase scans also show mild Tc-MDP uptake in the left hip joint soft tissues (arrowheads). No abnormalities are visualized in the region of the right hip joint.
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Subsequently, a bone scintigraphy study showed increased radiotracer uptake in the left hip periarticular region, suggesting active hyperemia and chronic inflammatory change, which were considered non-specific findings (Fig. 1).
85-year-old female with metallosis of left total hip replacement. AP Radiograph of the pelvis shows eccentric position of femoral head within acetabular cup of left total hip replacement. The bubble sign (arrows) and cloud sign (arrowheads) are present in the periprosthetic region of the left hip joint. The right total hip replacement is intact, with incidental heterotopic ossification.
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THR acetabular component (Figure 2A, Figure 2B, Figure 2C).
85-year-old female with metallosis of left total hip replacement. AP radiograph of the right hip shows eccentric position of the femoral head within the acetabular cup. The bubble sign (arrows) and cloud sign (arrowheads) are present in the periprosthetic region of the left hip joint.
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Post-operative pelvic radiographs demonstrated a well-positioned, well-fixed left THR with no signs of residual metallosis (Fig. 3).