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📌 Periprosthetic Infection
✅ Diagnostic Workup
- The diagnostic workup for infection begins with two nonspecific blood markers of inflammation: erythrocyte sedimentation rate and C-reactive protein concentration.
✅ Radiographic Findings
- Radiographic findings of infection can vary from completely normal to frank bone destruction mimicking loosening or particle disease.
- Typical radiograph findings include soft tissue swelling, large joint effusion, and periosteal reaction in severe cases.
- Periosteal new bone formation or adjacent soft tissue fluid collection are more specific but lack sensitivity.
- Periosteal reaction due to infection needs to be differentiated from that related to healing, which may be difficult.
📌 Periprosthetic Infection vs Aseptic Loosening
✅ Diagnostic Challenges
- Many patients with either infected TKA or aseptic loosening present with chronic indolent pain or loosening, making it challenging to distinguish between these conditions.
- Radiographic findings in infection, such as periprosthetic lucency, osteolysis, and prosthesis migration, may be seen in aseptic loosening as well.
- [Periprosthetic Infection] Periosteal new bone formation or adjacent soft tissue fluid collection are more specific but lack sensitivity.
References
- AJR 2014; 202:W76–W86
- Semin Musculoskelet Radiol 2017;21:147–164
- Semin Musculoskelet Radiol 2019;23:e20–e35.
"Visualizing MSK Radiology: A Practical Guide to Radiology Mastery"
© 2022 MSK MRI Jee Eun Lee All Rights Reserved.
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#PeriprostheticInfection, #RadiographicFindings, #DiagnosticWorkup, #InfectionMarkers, #TKAInfection, #AsepticLoosening, #ChronicPain, #Radiographs, #BoneDestruction, #JointEffusion
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