ABSTRACT
In an attempt to differentiate between loose and infected total joint replacements, seventy-nine patients were studied with both technetium-99 pyrophosphate and gallium-67 citrate bone scans. Seventy of these patients had positive technetium scans. Nineteen had positive gallium scans and all nineteen had positive cultures at the time of operation, while one patient had a false-negative gallium scan. Ten other patients who had negative technetium-99 scans and a painful total joint were followed without operative intervention. Of these, only two required operation after their technetium-99 scans became positive. Based on these studies, gallium-67 citrate scans combined with technetium-99 pyrophosphate scans are believed to be useful in differentiating between loose and infected prostheses. A negative technetium scan should weigh heavily against surgical exploration in an attempt to find the source of pain.
Subject(s)
Elbow Joint/diagnostic imaging , Hip Joint/diagnostic imaging , Joint Prosthesis , Knee Joint/diagnostic imaging , Aged , Bacterial Infections/diagnostic imaging , Bacterial Infections/etiology , Diagnosis, Differential , Elbow Joint/surgery , Female , Gallium Radioisotopes , Hip Joint/surgery , Hip Prosthesis , Humans , Joint Prosthesis/adverse effects , Knee Joint/surgery , Knee Prosthesis , Pain , Postoperative Complications/diagnostic imaging , Radionuclide Imaging , TechnetiumSubject(s)
Pseudarthrosis/congenital , Radius , Ulna , Child, Preschool , Humans , Male , Neurofibromatosis 1/complications , Neurofibromatosis 1/geneticsABSTRACT
This is a preliminary report of eleven patients with painful total joint arthroplasties. In their evaluation the difficulty in the differential diagnosis between the loose and the infected total joint becomes apparent. We have found the use of differential bone scans an accurate method to identify the infected total joint. Further study along these lines is indicated with a larger series and generalization to other types of implants.
