Diagnostic and prognostic relevance of plain radiographs for periprosthetic joint infections of the hip: a literature review

TY - JOUR

T1 - Diagnostic and prognostic relevance of plain radiographs for periprosthetic joint infections of the hip: a literature review

AU - Hofmann, Ulf Krister

AU - Eleftherakis, Georgios

AU - Migliorini, Filippo

AU - Fink, Bernd

AU - Mederake, Moritz

N1 - © 2024. The Author(s).

PY - 2024/6/8

Y1 - 2024/6/8

N2 - Conventional radiography is regularly used to evaluate complications after total hip arthroplasty. In various recent consensus meetings, however, plain radiographs of a potentially infected hip joint have been judged as being only relevant to exclude diagnoses other than infection. Solid data on radiographic presentations of periprosthetic joint infection (PJI) are scarce. As a result, the prognostic value of radiological features in low-grade PJI remains uncertain. The present review article aims to present an overview of the available literature and to develop ideas on future perspectives to define the diagnostic possibilities of radiography in PJIs of the hip. The primary outcome of interest of this systematic review was the radiologic presentation of periprosthetic joint infections of the hip. As secondary outcome of interest served the sensitivity and specificity of the radiologic presentation of periprosthetic joint infections. Of the included articles, 26 were reviews, essays, or case reports and only 18 were clinical studies. Typical radiologic abnormalities of PJI were a periosteal reaction, a wide band of radiolucency at the cement-bone or metal-bone interface, patchy osteolysis, implant loosening, bone resorption around the implant, and transcortical sinus tracts. The frequency of their occurrence is still inadequately defined. A deeper understanding of the underlying causes and the relation between microorganisms to radiologic abnormalities can probably help clinicians in the future to diagnose a PJI. This is why further research shall focus on the radiographic features of PJI.

AB - Conventional radiography is regularly used to evaluate complications after total hip arthroplasty. In various recent consensus meetings, however, plain radiographs of a potentially infected hip joint have been judged as being only relevant to exclude diagnoses other than infection. Solid data on radiographic presentations of periprosthetic joint infection (PJI) are scarce. As a result, the prognostic value of radiological features in low-grade PJI remains uncertain. The present review article aims to present an overview of the available literature and to develop ideas on future perspectives to define the diagnostic possibilities of radiography in PJIs of the hip. The primary outcome of interest of this systematic review was the radiologic presentation of periprosthetic joint infections of the hip. As secondary outcome of interest served the sensitivity and specificity of the radiologic presentation of periprosthetic joint infections. Of the included articles, 26 were reviews, essays, or case reports and only 18 were clinical studies. Typical radiologic abnormalities of PJI were a periosteal reaction, a wide band of radiolucency at the cement-bone or metal-bone interface, patchy osteolysis, implant loosening, bone resorption around the implant, and transcortical sinus tracts. The frequency of their occurrence is still inadequately defined. A deeper understanding of the underlying causes and the relation between microorganisms to radiologic abnormalities can probably help clinicians in the future to diagnose a PJI. This is why further research shall focus on the radiographic features of PJI.

KW - Humans

KW - Prosthesis-Related Infections/diagnostic imaging

KW - Prognosis

KW - Arthroplasty, Replacement, Hip/adverse effects

KW - Radiography/methods

KW - Hip Joint/diagnostic imaging

KW - Hip Prosthesis/adverse effects

U2 - 10.1186/s40001-024-01891-8

DO - 10.1186/s40001-024-01891-8

M3 - SCORING: Review article

C2 - 38849967

VL - 29

SP - 314

JO - EUR J MED RES

JF - EUR J MED RES

SN - 0949-2321

IS - 1

ER -