AC Portal
Document Navigator

Imaging after Total Hip Arthroplasty

Variant: 1   Routine follow-up of the asymptomatic patient after hip arthroplasty.
Procedure Appropriateness Category Relative Radiation Level
Radiography hip Usually Appropriate ☢☢☢
US hip Usually Not Appropriate O
MRI hip without and with IV contrast Usually Not Appropriate O
MRI hip without IV contrast Usually Not Appropriate O
Bone scan hip Usually Not Appropriate ☢☢☢
Bone scan with SPECT or SPECT/CT hip Usually Not Appropriate ☢☢☢
CT hip with IV contrast Usually Not Appropriate ☢☢☢
CT hip without and with IV contrast Usually Not Appropriate ☢☢☢
CT hip without IV contrast Usually Not Appropriate ☢☢☢
Fluoride PET/CT skull base to mid-thigh Usually Not Appropriate ☢☢☢☢

Variant: 2   Symptomatic patient with hip prosthesis. Initial imaging.
Procedure Appropriateness Category Relative Radiation Level
Radiography hip Usually Appropriate ☢☢☢
US hip Usually Not Appropriate O
Image-guided aspiration hip Usually Not Appropriate Varies
MRI hip without and with IV contrast Usually Not Appropriate O
MRI hip without IV contrast Usually Not Appropriate O
Bone scan hip Usually Not Appropriate ☢☢☢
Bone scan with SPECT or SPECT/CT hip Usually Not Appropriate ☢☢☢
CT hip with IV contrast Usually Not Appropriate ☢☢☢
CT hip without and with IV contrast Usually Not Appropriate ☢☢☢
CT hip without IV contrast Usually Not Appropriate ☢☢☢
Fluoride PET/CT skull base to mid-thigh Usually Not Appropriate ☢☢☢☢

Variant: 3   Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs.
Procedure Appropriateness Category Relative Radiation Level
CT hip without IV contrast Usually Appropriate ☢☢☢
MRI hip without IV contrast May Be Appropriate O
US hip Usually Not Appropriate O
Image-guided aspiration hip Usually Not Appropriate Varies
MRI hip without and with IV contrast Usually Not Appropriate O
Bone scan hip Usually Not Appropriate ☢☢☢
Bone scan with SPECT or SPECT/CT hip Usually Not Appropriate ☢☢☢
CT hip with IV contrast Usually Not Appropriate ☢☢☢
CT hip without and with IV contrast Usually Not Appropriate ☢☢☢
Bone scan and gallium scan hip Usually Not Appropriate ☢☢☢☢
Bone scan and gallium scan with SPECT or SPECT/CT hip Usually Not Appropriate ☢☢☢☢
FDG-PET/CT skull base to mid-thigh Usually Not Appropriate ☢☢☢☢
Fluoride PET/CT skull base to mid-thigh Usually Not Appropriate ☢☢☢☢
WBC scan and sulfur colloid scan hip Usually Not Appropriate ☢☢☢☢

Variant: 4   Symptomatic hip arthroplasty patient, infection not excluded. Additional imaging following radiographs.
Procedure Appropriateness Category Relative Radiation Level
Image-guided aspiration hip Usually Appropriate Varies
MRI hip without IV contrast Usually Appropriate O
WBC scan and sulfur colloid scan hip Usually Appropriate ☢☢☢☢
US hip May Be Appropriate O
MRI hip without and with IV contrast May Be Appropriate O
CT hip with IV contrast May Be Appropriate ☢☢☢
CT hip without IV contrast May Be Appropriate ☢☢☢
Radiographic arthrography hip Usually Not Appropriate ☢
Bone scan hip Usually Not Appropriate ☢☢☢
Bone scan with SPECT or SPECT/CT hip Usually Not Appropriate ☢☢☢
CT hip without and with IV contrast Usually Not Appropriate ☢☢☢
Bone scan and gallium scan hip Usually Not Appropriate ☢☢☢☢
Bone scan and gallium scan with SPECT or SPECT/CT hip Usually Not Appropriate ☢☢☢☢
FDG-PET/CT skull base to mid-thigh Usually Not Appropriate ☢☢☢☢
Fluoride PET/CT skull base to mid-thigh Usually Not Appropriate ☢☢☢☢

Variant: 5   Symptomatic hip arthroplasty patient, infection excluded. Additional imaging following radiographs.
Procedure Appropriateness Category Relative Radiation Level
MRI hip without IV contrast Usually Appropriate O
CT hip without IV contrast Usually Appropriate ☢☢☢
Image-guided anesthetic injection hip May Be Appropriate Varies
Bone scan with SPECT or SPECT/CT hip May Be Appropriate ☢☢☢
Radiographic arthrography hip Usually Not Appropriate ☢
MRI hip without and with IV contrast Usually Not Appropriate O
Bone scan hip Usually Not Appropriate ☢☢☢
CT arthrography hip Usually Not Appropriate ☢☢☢
CT hip with IV contrast Usually Not Appropriate ☢☢☢
CT hip without and with IV contrast Usually Not Appropriate ☢☢☢
Fluoride PET/CT skull base to mid-thigh Usually Not Appropriate ☢☢☢☢

Variant: 6   Evaluation of symptomatic hip arthroplasty patient with metal-on-metal prosthesis or findings suggesting trunnionosis. Question of adverse reaction to metal debris. Additional imaging following radiographs.
Procedure Appropriateness Category Relative Radiation Level
MRI hip without IV contrast Usually Appropriate O
US hip May Be Appropriate O
CT hip without IV contrast May Be Appropriate ☢☢☢
MRI hip without and with IV contrast Usually Not Appropriate O
CT hip with IV contrast Usually Not Appropriate ☢☢☢
CT hip without and with IV contrast Usually Not Appropriate ☢☢☢

Variant: 7   Hip arthroplasty patient with trochanteric pain. Suspect abductor injury, or trochanteric bursitis, or other soft tissue abnormality. Additional imaging following radiographs.
Procedure Appropriateness Category Relative Radiation Level
US hip Usually Appropriate O
MRI hip without IV contrast Usually Appropriate O
Image-guided anesthetic +/- corticosteroid injection hip joint or surrounding structures May Be Appropriate Varies
Radiographic arthrography hip Usually Not Appropriate ☢
MRI hip without and with IV contrast Usually Not Appropriate O
CT hip with IV contrast Usually Not Appropriate ☢☢☢
CT hip without and with IV contrast Usually Not Appropriate ☢☢☢
CT hip without IV contrast Usually Not Appropriate ☢☢☢

Panel Members
Barbara N. Weissman, MDa; Christopher J. Palestro, MDb; Michael G. Fox, MD, MBAc; Angela M. Bell, MDd; Donna G. Blankenbaker, MDe; Matthew A. Frick, MDf; Shari T. Jawetz, MDg; Phillip H. Kuo, MD, PhDh; Nicholas Said, MD, MBAi; J. Derek Stensby, MDj; Naveen Subhas, MD, MPHk; Katherine M. Tynus, MDl; Eric A. Walker, MD, MHAm; Mark J. Kransdorf, MDn.
Summary of Literature Review
Introduction/Background
Special Imaging Considerations
Initial Imaging Definition

Initial imaging is defined as imaging at the beginning of the care episode for the medical condition defined by the variant. More than one procedure can be considered usually appropriate in the initial imaging evaluation when:

  • There are procedures that are equivalent alternatives (i.e., only one procedure will be ordered to provide the clinical information to effectively manage the patient’s care)

OR

  • There are complementary procedures (i.e., more than one procedure is ordered as a set or simultaneously wherein each procedure provides unique clinical information to effectively manage the patient’s care).
Discussion of Procedures by Variant
Variant 1: Routine follow-up of the asymptomatic patient after hip arthroplasty.
Variant 1: Routine follow-up of the asymptomatic patient after hip arthroplasty.
A. Bone scan hip
Variant 1: Routine follow-up of the asymptomatic patient after hip arthroplasty.
B. Bone scan with SPECT or SPECT/CT hip
Variant 1: Routine follow-up of the asymptomatic patient after hip arthroplasty.
C. CT hip
Variant 1: Routine follow-up of the asymptomatic patient after hip arthroplasty.
D. Fluoride PET/CT skull base to mid-thigh
Variant 1: Routine follow-up of the asymptomatic patient after hip arthroplasty.
E. MRI hip
Variant 1: Routine follow-up of the asymptomatic patient after hip arthroplasty.
F. Radiography hip
Variant 1: Routine follow-up of the asymptomatic patient after hip arthroplasty.
G. US hip
Variant 2: Symptomatic patient with hip prosthesis. Initial imaging.
Variant 2: Symptomatic patient with hip prosthesis. Initial imaging.
A. Bone scan hip
Variant 2: Symptomatic patient with hip prosthesis. Initial imaging.
B. Bone scan with SPECT or SPECT/CT hip
Variant 2: Symptomatic patient with hip prosthesis. Initial imaging.
C. CT hip
Variant 2: Symptomatic patient with hip prosthesis. Initial imaging.
D. Fluoride PET/CT skull base to mid-thigh
Variant 2: Symptomatic patient with hip prosthesis. Initial imaging.
E. Image-guided aspiration hip
Variant 2: Symptomatic patient with hip prosthesis. Initial imaging.
F. MRI hip
Variant 2: Symptomatic patient with hip prosthesis. Initial imaging.
G. Radiography hip
Variant 2: Symptomatic patient with hip prosthesis. Initial imaging.
H. US hip
Variant 3: Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs.
Variant 3: Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs.
A. Bone scan and gallium scan hip
Variant 3: Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs.
B. Bone scan and gallium scan with SPECT or SPECT/CT hip
Variant 3: Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs.
C. Bone scan hip
Variant 3: Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs.
D. Bone scan with SPECT or SPECT/CT hip
Variant 3: Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs.
E. CT hip
Variant 3: Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs.
F. FDG-PET/CT skull base to mid-thigh
Variant 3: Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs.
G. Fluoride PET/CT skull base to mid-thigh
Variant 3: Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs.
H. Image-guided aspiration hip
Variant 3: Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs.
I. MRI hip
Variant 3: Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs.
J. US hip
Variant 3: Symptomatic hip arthroplasty patient, history of acute injury. Additional imaging following radiographs.
K. WBC scan and sulfur colloid scan hip
Variant 4: Symptomatic hip arthroplasty patient, infection not excluded. Additional imaging following radiographs.
Variant 4: Symptomatic hip arthroplasty patient, infection not excluded. Additional imaging following radiographs.
A. Bone scan and gallium scan hip
Variant 4: Symptomatic hip arthroplasty patient, infection not excluded. Additional imaging following radiographs.
B. Bone scan and gallium scan with SPECT or SPECT/CT hip
Variant 4: Symptomatic hip arthroplasty patient, infection not excluded. Additional imaging following radiographs.
C. Bone scan hip
Variant 4: Symptomatic hip arthroplasty patient, infection not excluded. Additional imaging following radiographs.
D. Bone scan with SPECT or SPECT/CT hip
Variant 4: Symptomatic hip arthroplasty patient, infection not excluded. Additional imaging following radiographs.
E. CT hip
Variant 4: Symptomatic hip arthroplasty patient, infection not excluded. Additional imaging following radiographs.
F. FDG-PET/CT skull base to mid-thigh
Variant 4: Symptomatic hip arthroplasty patient, infection not excluded. Additional imaging following radiographs.
G. Fluoride PET/CT skull base to mid-thigh
Variant 4: Symptomatic hip arthroplasty patient, infection not excluded. Additional imaging following radiographs.
H. Image-guided aspiration hip
Variant 4: Symptomatic hip arthroplasty patient, infection not excluded. Additional imaging following radiographs.
I. MRI hip
Variant 4: Symptomatic hip arthroplasty patient, infection not excluded. Additional imaging following radiographs.
J. Radiographic arthrography hip
Variant 4: Symptomatic hip arthroplasty patient, infection not excluded. Additional imaging following radiographs.
K. US hip
Variant 4: Symptomatic hip arthroplasty patient, infection not excluded. Additional imaging following radiographs.
L. WBC scan and sulfur colloid scan hip
Variant 5: Symptomatic hip arthroplasty patient, infection excluded. Additional imaging following radiographs.
Variant 5: Symptomatic hip arthroplasty patient, infection excluded. Additional imaging following radiographs.
A. Bone scan hip
Variant 5: Symptomatic hip arthroplasty patient, infection excluded. Additional imaging following radiographs.
B. Bone scan with SPECT or SPECT/CT hip
Variant 5: Symptomatic hip arthroplasty patient, infection excluded. Additional imaging following radiographs.
C. CT arthrography hip
Variant 5: Symptomatic hip arthroplasty patient, infection excluded. Additional imaging following radiographs.
D. CT hip
Variant 5: Symptomatic hip arthroplasty patient, infection excluded. Additional imaging following radiographs.
E. Fluoride PET/CT skull base to mid-thigh
Variant 5: Symptomatic hip arthroplasty patient, infection excluded. Additional imaging following radiographs.
F. Image-guided anesthetic injection hip
Variant 5: Symptomatic hip arthroplasty patient, infection excluded. Additional imaging following radiographs.
G. MRI hip
Variant 5: Symptomatic hip arthroplasty patient, infection excluded. Additional imaging following radiographs.
H. Radiographic arthrography hip
Variant 6: Evaluation of symptomatic hip arthroplasty patient with metal-on-metal prosthesis or findings suggesting trunnionosis. Question of adverse reaction to metal debris. Additional imaging following radiographs.
Variant 6: Evaluation of symptomatic hip arthroplasty patient with metal-on-metal prosthesis or findings suggesting trunnionosis. Question of adverse reaction to metal debris. Additional imaging following radiographs.
A. CT hip
Variant 6: Evaluation of symptomatic hip arthroplasty patient with metal-on-metal prosthesis or findings suggesting trunnionosis. Question of adverse reaction to metal debris. Additional imaging following radiographs.
B. MRI hip
Variant 6: Evaluation of symptomatic hip arthroplasty patient with metal-on-metal prosthesis or findings suggesting trunnionosis. Question of adverse reaction to metal debris. Additional imaging following radiographs.
C. US hip
Variant 7: Hip arthroplasty patient with trochanteric pain. Suspect abductor injury, or trochanteric bursitis, or other soft tissue abnormality. Additional imaging following radiographs.
Variant 7: Hip arthroplasty patient with trochanteric pain. Suspect abductor injury, or trochanteric bursitis, or other soft tissue abnormality. Additional imaging following radiographs.
A. CT hip with IV contrast
Variant 7: Hip arthroplasty patient with trochanteric pain. Suspect abductor injury, or trochanteric bursitis, or other soft tissue abnormality. Additional imaging following radiographs.
B. Image-guided anesthetic +/- corticosteroid injection hip joint or surrounding structures
Variant 7: Hip arthroplasty patient with trochanteric pain. Suspect abductor injury, or trochanteric bursitis, or other soft tissue abnormality. Additional imaging following radiographs.
C. MRI hip without and with IV contrast
Variant 7: Hip arthroplasty patient with trochanteric pain. Suspect abductor injury, or trochanteric bursitis, or other soft tissue abnormality. Additional imaging following radiographs.
D. Radiographic arthrography hip
Variant 7: Hip arthroplasty patient with trochanteric pain. Suspect abductor injury, or trochanteric bursitis, or other soft tissue abnormality. Additional imaging following radiographs.
E. US hip
Summary of Highlights
Supporting Documents

The evidence table, literature search, and appendix for this topic are available at https://acsearch.acr.org/list. The appendix includes the strength of evidence assessment and the final rating round tabulations for each recommendation.

For additional information on the Appropriateness Criteria methodology and other supporting documents, please go to the ACR website at https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Appropriateness-Criteria.

Gender Equality and Inclusivity Clause
The ACR acknowledges the limitations in applying inclusive language when citing research studies that predates the use of the current understanding of language inclusive of diversity in sex, intersex, gender, and gender-diverse people. The data variables regarding sex and gender used in the cited literature will not be changed. However, this guideline will use the terminology and definitions as proposed by the National Institutes of Health.
Appropriateness Category Names and Definitions

Appropriateness Category Name

Appropriateness Rating

Appropriateness Category Definition

Usually Appropriate

7, 8, or 9

The imaging procedure or treatment is indicated in the specified clinical scenarios at a favorable risk-benefit ratio for patients.

May Be Appropriate

4, 5, or 6

The imaging procedure or treatment may be indicated in the specified clinical scenarios as an alternative to imaging procedures or treatments with a more favorable risk-benefit ratio, or the risk-benefit ratio for patients is equivocal.

May Be Appropriate (Disagreement)

5

The individual ratings are too dispersed from the panel median. The different label provides transparency regarding the panel’s recommendation. “May be appropriate” is the rating category and a rating of 5 is assigned.

Usually Not Appropriate

1, 2, or 3

The imaging procedure or treatment is unlikely to be indicated in the specified clinical scenarios, or the risk-benefit ratio for patients is likely to be unfavorable.
Relative Radiation Level Information

Potential adverse health effects associated with radiation exposure are an important factor to consider when selecting the appropriate imaging procedure. Because there is a wide range of radiation exposures associated with different diagnostic procedures, a relative radiation level (RRL) indication has been included for each imaging examination. The RRLs are based on effective dose, which is a radiation dose quantity that is used to estimate population total radiation risk associated with an imaging procedure. Patients in the pediatric age group are at inherently higher risk from exposure, because of both organ sensitivity and longer life expectancy (relevant to the long latency that appears to accompany radiation exposure). For these reasons, the RRL dose estimate ranges for pediatric examinations are lower as compared with those specified for adults (see Table below). Additional information regarding radiation dose assessment for imaging examinations can be found in the ACR Appropriateness Criteria® Radiation Dose Assessment Introduction document.

Relative Radiation Level Designations

Relative Radiation Level*

Adult Effective Dose Estimate Range

Pediatric Effective Dose Estimate Range

O

0 mSv

 0 mSv

☢

<0.1 mSv

<0.03 mSv

☢☢

0.1-1 mSv

0.03-0.3 mSv

☢☢☢

1-10 mSv

0.3-3 mSv

☢☢☢☢

10-30 mSv

3-10 mSv

☢☢☢☢☢

30-100 mSv

10-30 mSv

*RRL assignments for some of the examinations cannot be made, because the actual patient doses in these procedures vary as a function of a number of factors (e.g., region of the body exposed to ionizing radiation, the imaging guidance that is used). The RRLs for these examinations are designated as “Varies.”
References
1. Charnley J. Arthroplasty of the hip. A new operation. Lancet 1961;1:1129-32.
2. Sloan M, Premkumar A, Sheth NP. Projected Volume of Primary Total Joint Arthroplasty in the U.S., 2014 to 2030. J Bone Joint Surg Am 2018;100:1455-60.
3. Hu CY, Yoon TR. Recent updates for biomaterials used in total hip arthroplasty. Biomater Res 2018;22:33.
4. Merola M, Affatato S. Materials for Hip Prostheses: A Review of Wear and Loading Considerations. Materials (Basel) 2019;12.
5. Rochcongar G, Remazeilles M, Bourroux E, et al. Reduced wear in vitamin E-infused highly cross-linked polyethylene cups: 5-year results of a randomized controlled trial. Acta Orthop 2021;92:151-55.
6. Chang EY, McAnally JL, Van Horne JR, et al. Metal-on-metal total hip arthroplasty: do symptoms correlate with MR imaging findings? Radiology. 2012;265:848-57.
7. Yanny S, Cahir JG, Barker T, et al. MRI of aseptic lymphocytic vasculitis-associated lesions in metal-on-metal hip replacements. J Bone Joint Surg Am. 2012;198:1394-402.
8. Madanat R, Hussey DK, Donahue GS, et al. Early Lessons From a Worldwide, Multicenter, Followup Study of the Recalled Articular Surface Replacement Hip System. Clin Orthop. 474(1):166-74, 2016 Jan.
9. Nawabi DH, Gold S, Lyman S, Fields K, Padgett DE, Potter HG. MRI predicts ALVAL and tissue damage in metal-on-metal hip arthroplasty. Clinical Orthopaedics &#38; Related Research. 472(2):471-81, 2014 Feb.Clin Orthop. 472(2):471-81, 2014 Feb.
10. Bolognesi MP, Ledford CK. Metal-on-Metal Total Hip Arthroplasty: Patient Evaluation and Treatment. [Review]. J Am Acad Orthop Surg. 23(12):724-31, 2015 Dec.
11. Langton DJ, Jameson SS, Joyce TJ, Hallab NJ, Natu S, Nargol AV. Early failure of metal-on-metal bearings in hip resurfacing and large-diameter total hip replacement: A consequence of excess wear. J Bone Joint Surg Br 2010;92:38-46.
12. Lohmann CH, Singh G, Willert HG, Buchhorn GH. Metallic debris from metal-on-metal total hip arthroplasty regulates periprosthetic tissues. World J Orthop 2014;5:660-6.
13. McGrory BJ, Jacobs JJ, Kwon YM, Fillingham Y. Standardizing terms for tribocorrosion-associated adverse local tissue reaction in total hip arthroplasty. Arthroplast Today 2020;6:196-200.
14. Chang JD, Lee SS, Hur M, Seo EM, Chung YK, Lee CJ. Revision total hip arthroplasty in hip joints with metallosis: a single-center experience with 31 cases. J Arthroplasty 2005;20:568-73.
15. American Joint Replacement Registry (AJRR): 2021 Annual Report. Rosemont, IL: American Academy of Orthopaedic Surgeons (AAOS).  Available at: https://www.aaos.org/registries/publications/ajrr-annual-report/.
16. Gwam CU, Mistry JB, Mohamed NS, et al. Current Epidemiology of Revision Total Hip Arthroplasty in the United States: National Inpatient Sample 2009 to 2013. J Arthroplasty 2017;32:2088-92.
17. Healy WL, Iorio R, Clair AJ, Pellegrini VD, Della Valle CJ, Berend KR. Complications of Total Hip Arthroplasty: Standardized List, Definitions, and Stratification Developed by The Hip Society. Clin Orthop Relat Res 2016;474:357-64.
18. Fritz J, Lurie B, Miller TT. Imaging of hip arthroplasty. Semin Musculoskelet Radiol. 2013;17(3):316-327.
19. Fritz J, Lurie B, Miller TT, Potter HG. MR imaging of hip arthroplasty implants. Radiographics 2014;34:E106-32.
20. Khodarahmi I, Nittka M, Fritz J. Leaps in Technology: Advanced MR Imaging after Total Hip Arthroplasty. [Review]. Semin Musculoskelet Radiol. 21(5):604-615, 2017 Nov.
21. Koff MF, Burge AJ, Potter HG. Clinical magnetic resonance imaging of arthroplasty at 1.5 T. J Orthop Res 2020;38:1455-64.
22. Roth TD, Maertz NA, Parr JA, Buckwalter KA, Choplin RH. CT of the hip prosthesis: appearance of components, fixation, and complications. Radiographics. 2012;32:1089-1107.
23. Blum A, Meyer JB, Raymond A, et al. CT of hip prosthesis: New techniques and new paradigms. Diagn Interv Imaging. 97(7-8):725-33, 2016 Jul-Aug.
24. Hacking C, Weinrauch P, Whitehouse SL, Crawford RW, Donnelly WJ. Is there a need for routine follow-up after primary total hip arthroplasty? ANZ J Surg. 2010;80:737-40.
25. Oswald SG, Van Nostrand D, Savory CG, Anderson JH, Callaghan JJ. The acetabulum: a prospective study of three-phase bone and indium white blood cell scintigraphy following porous-coated hip arthroplasty. J Nucl Med 1990;31:274-80.
26. Oswald SG, Van Nostrand D, Savory CG, Callaghan JJ. Three-phase bone scan and indium white blood cell scintigraphy following porous coated hip arthroplasty: a prospective study of the prosthetic tip. J Nucl Med. 1989;30:1321-31.
27. Utz JA, Lull RJ, Galvin EG. Asymptomatic total hip prosthesis: natural history determined using Tc-99m MDP bone scans. Radiology. 1986;161:509-12.
28. Tam HH, Bhaludin B, Rahman F, Weller A, Ejindu V, Parthipun A. SPECT-CT in total hip arthroplasty. Clin Radiol 2014;69:82-95.
29. Ullmark G, Nilsson O, Maripuu E, Sorensen J. Analysis of bone mineralization on uncemented femoral stems by [18F]-fluoride-PET: a randomized clinical study of 16 hips in 8 patients. Acta Orthop. 2013;84(2):138-144.
30. Ullmark G, Sorensen J, Nilsson O. Analysis of bone formation on porous and calcium phosphate-coated acetabular cups: a randomised clinical [18F]fluoride PET study. Hip Int. 2012;22(2):172-178.
31. Cooper HJ, Ranawat AS, Potter HG, Foo LF, Koob TW, Ranawat CS. Early reactive synovitis and osteolysis after total hip arthroplasty. Clin Orthop Relat Res. 2010;468:3278-85.
32. Filli L, Jungmann PM, Zingg PO, et al. MRI with state-of-the-art metal artifact reduction after total hip arthroplasty: periprosthetic findings in asymptomatic and symptomatic patients. Eur Radiol. 30(4):2241-2252, 2020 Apr.
33. Koff MF, Gao MA, Neri JP, et al. Adverse Local Tissue Reactions are Common in Asymptomatic Individuals After Hip Resurfacing Arthroplasty: Interim Report from a Prospective Longitudinal Study. Clin Orthop Relat Res 2021;479:2633-50.
34. Bozza N, Guindani N, Pezzotta G, Alberto F, Castelli CC. 15-year follow-up of MoM 36-mm THA: clinical, laboratory, and radiological (CT and MRI) prospective assessment. Hip int.. 30(2_suppl):42-51, 2020 Dec.
35. Kwon YM, Liow MH, Dimitriou D, Tsai TY, Freiberg AA, Rubash HE. What Is the Natural History of "Asymptomatic" Pseudotumours in Metal-on-Metal Hip Arthroplasty? Minimum 4-Year Metal Artifact Reduction Sequence Magnetic Resonance Imaging Longitudinal Study. J Arthroplasty 2016;31:121-6.
36. Matharu GS, Judge A, Eskelinen A, Murray DW, Pandit HG. What is appropriate surveillance for metal-on-metal hip arthroplasty patients?. Acta Orthop. 89(1):29-39, 2018 Feb.
37. Mistry A, Cahir J, Donell ST, Nolan J, Toms AP. MRI of asymptomatic patients with metal-on-metal and polyethylene-on-metal total hip arthroplasties. Clin Radiol. 2011;66:540-5.
38. van der Weegen W, Smolders JM, Sijbesma T, Hoekstra HJ, Brakel K, van Susante JL. High incidence of pseudotumours after hip resurfacing even in low risk patients; results from an intensified MRI screening protocol. Hip Int 2013;23:243-9.
39. Lainiala O, Elo P, Reito A, Pajamaki J, Puolakka T, Eskelinen A. Comparison of extracapsular pseudotumors seen in magnetic resonance imaging and in revision surgery of 167 failed metal-on-metal hip replacements. Acta Orthop 2014;85:474-9.
40. Liddle AD, Satchithananda K, Henckel J, et al. Revision of metal-on-metal hip arthroplasty in a tertiary center: a prospective study of 39 hips with between 1 and 4 years of follow-up. Acta Orthop 2013;84:237-45.
41. Nishii T, Sakai T, Takao M, Yoshikawa H, Sugano N. Is ultrasound screening reliable for adverse local tissue reaction after hip arthroplasty? J Arthroplasty 2014;29:2239-44.
42. Chang CY, Huang AJ, Palmer WE. Radiographic evaluation of hip implants. [Review]. Semin Musculoskelet Radiol. 19(1):12-20, 2015 Feb.
43. Hart AA, DeMik DE, Brown TS, Noiseux NO. Routine Radiographs After Total Joint Arthroplasty: Is There Clinical Value?. J Arthroplasty. 36(7):2431-2434, 2021 07.
44. U.S. FDA: Concerns about Metal-on-Metal Hip Implants.  Available at: https://www.fda.gov/medical-devices/metal-metal-hip-implants/concerns-about-metal-metal-hip-implants.
45. Madanat R, Rolfson O, Donahue GS, et al. Medial Calcar Erosion Is Associated With Synovial Thickness in Patients With ASR XL Total Hip Arthroplasty. J Arthroplasty. 31(11):2588-2592, 2016 11.
46. Williams DH, Greidanus NV, Masri BA, Duncan CP, Garbuz DS. Prevalence of pseudotumor in asymptomatic patients after metal-on-metal hip arthroplasty. J Bone Joint Surg Am. 2011;93:2164-71.
47. Douis H, Dunlop DJ, Pearson AM, O'Hara JN, James SL. The role of ultrasound in the assessment of post-operative complications following hip arthroplasty. Skeletal Radiol. 2012;41:1035-46.
48. Kwon YM, Ostlere SJ, McLardy-Smith P, Athanasou NA, Gill HS, Murray DW. "Asymptomatic" pseudotumors after metal-on-metal hip resurfacing arthroplasty: prevalence and metal ion study. J Arthroplasty. 2011;26:511-8.
49. Petscavage-Thomas JM, Ha A. Best Practices: Best Imaging Modality for Surveillance of Metal-on-Metal Hip Arthroplasty. AJR Am J Roentgenol 2021;216:311-17.
50. Low AK, Matharu GS, Ostlere SJ, Murray DW, Pandit HG. How Should We Follow-Up Asymptomatic Metal-on-Metal Hip Resurfacing Patients? A Prospective Longitudinal Cohort Study. J Arthroplasty. 31(1):146-51, 2016 Jan.
51. Lainiala O, Elo P, Reito A, Pajamaki J, Puolakka T, Eskelinen A. Good sensitivity and specificity of ultrasound for detecting pseudotumors in 83 failed metal-on-metal hip replacements. Acta Orthop 2015;86:339-44.
52. Kwon YM, Dimitriou D, Liow MH, Tsai TY, Li G. Is Ultrasound As Useful As Metal Artifact Reduction Sequence Magnetic Resonance Imaging in Longitudinal Surveillance of Metal-on-Metal Hip Arthroplasty Patients? J Arthroplasty 2016;31:1821-7.
53. Endo Y, Renner L, Schmidt-Braekling T, Mintz DN, Boettner F. Imaging of ceramic liner fractures in total hip arthroplasty: the value of CT. Skeletal Radiol. 44(8):1189-92, 2015 Aug.
54. Matharu GS, Blanshard O, Dhaliwal K, Judge A, Murray DW, Pandit HG. Patient and Radiographic Factors Help to Predict Metal-on-Metal Hip Resurfacings with Evidence of a Pseudotumor. J Bone Joint Surg Am 2017;99:214-22.
55. Chong AC, MacFadden LN, Piatt BE, Noonan BC. Is Plain Anterior-Posterior Radiograph of the Pelvis Adequate for Assessment of Radiographic Implant Migration Evaluation in Total Hip Arthroplasty?. Iowa Orthop J. 40(1):53-60, 2020.
56. Kwon YM, An S, Yeo I, Tirumala V, Chen W, Klemt C. Radiographic Risk Factors Associated With Adverse Local Tissue Reaction in Head-Neck Taper Corrosion of Primary Metal-on-Polyethylene Total Hip Arthroplasty. J Am Acad Orthop Surg. 29(8):353-360, 2021 Apr 15.
57. Mastel M, Boisvert A, Moore R, Sutherland F, Powell J. Metallosis following hip arthroplasty: two case reports. J Med Case Rep 2022;16:115.
58. Paydar A, Chew FS, Manner PA. Severe Periprosthetic Metallosis and Polyethylene Liner Failure Complicating Total Hip Replacement: The Cloud Sign. Radiol Case Rep 2007;2:115.
59. Su EP, Callander PW, Salvati EA. The bubble sign: a new radiographic sign in total hip arthroplasty. J Arthroplasty 2003;18:110-2.
60. Tigges S, Stiles RG, Roberson JR. Appearance of septic hip prostheses on plain radiographs. J Bone Joint Surg Am. 1994;163:377-80.
61. Stumpe KD, Notzli HP, Zanetti M, et al. FDG PET for differentiation of infection and aseptic loosening in total hip replacements: comparison with conventional radiography and three-phase bone scintigraphy. Radiology. 2004;231:333-41.
62. Steinert L, Zanetti M, Hodler J, Pfirrmann CW, Dora C, Saupe N. Are radiographic trochanteric surface irregularities associated with abductor tendon abnormalities? Radiology. 2010;257(3):754-763.
63. Barrett MC, Robertson-Waters EE, Whitehouse MR, Blom AW, Berstock JR. Trochanteric spurs and surface irregularities on plain radiography are not predictive of greater trochanteric pain syndrome. Hip int.. 30(2):176-180, 2020 Mar.
64. Mulcahy H, Chew FS. Current concepts of hip arthroplasty for radiologists: part 2, revisions and complications. AJR Am J Roentgenol 2012;199:570-80.
65. Kwon YM, Lombardi AV, Jacobs JJ, Fehring TK, Lewis CG, Cabanela ME. Risk stratification algorithm for management of patients with metal-on-metal hip arthroplasty: consensus statement of the American Association of Hip and Knee Surgeons, the American Academy of Orthopaedic Surgeons, and the Hip Society. J Bone Joint Surg Am 2014;96:e4.
66. Matharu GS, Mansour R, Dada O, Ostlere S, Pandit HG, Murray DW. Which imaging modality is most effective for identifying pseudotumours in metal-on-metal hip resurfacings requiring revision: ultrasound or MARS-MRI or both?. Bone Joint J. 98-B(1):40-8, 2016 Jan.
67. Andriamananaivo T, Odri GA, Ollivier M, et al. Contribution of the remaining attachment index in the management of Vancouver B1 periprosthetic hip fracture. Orthop Traumatol Surg Res. 106(7):1413-1417, 2020 Nov.
68. Baba T, Homma Y, Ochi H, et al. Higher reliability and validity of Baba classification with computerised tomography imaging and implant information for periprosthetic femoral fractures. Int Orthop. 39(9):1695-9, 2015 Sep.
69. Cinotti G, Sinno E, Fornara G, LaTorre G, Giannicola G. Plain films are not accurate in planning internal fixation in vancouver type B1 periprosthetic femoral fractures and in distinguishing between subtypes B1 And B2. Injury. 52(6):1592-1596, 2021 Jun.
70. Marshall RA, Weaver MJ, Sodickson A, Khurana B. Periprosthetic Femoral Fractures in the Emergency Department: What the Orthopedic Surgeon Wants to Know. Radiographics 2017;37:1202-17.
71. Rupp M, Kern S, Ismat A, et al. Computed tomography for managing periprosthetic femoral fractures. A retrospective analysis. BMC Musculoskelet Disord. 20(1):258, 2019 May 29.
72. Burge AJ.. Total hip arthroplasty: MR imaging of complications unrelated to metal wear. [Review]. Semin Musculoskelet Radiol. 19(1):31-9, 2015 Feb.
73. Long SS, Surrey D, Nazarian LN. Common sonographic findings in the painful hip after hip arthroplasty. J Ultrasound Med. 2012;31(2):301-312.
74. Ong KL, Kurtz SM, Lau E, Bozic KJ, Berry DJ, Parvizi J. Prosthetic joint infection risk after total hip arthroplasty in the Medicare population. J Arthroplasty. 2009;24:105-9.
75. Parvizi J, Gehrke T, International Consensus Group on Periprosthetic Joint I. Definition of periprosthetic joint infection. J Arthroplasty 2014;29:1331.
76. Chen AF, Riedel S. A Case Illustrating the Practical Application of the AAOS Clinical Practice Guideline: Diagnosis and Prevention of Periprosthetic Joint Infection. J Am Acad Orthop Surg 2020;28:e1081-e85.
77. Gomez-Luzuriaga MA, Galan V, Villar JM. Scintigraphy with Tc, Ga and In in painful total hip prostheses. Int Orthop. 1988;12:163-7.
78. Kraemer WJ, Saplys R, Waddell JP, Morton J. Bone scan, gallium scan, and hip aspiration in the diagnosis of infected total hip arthroplasty. J Arthroplasty 1993;8:611-6.
79. Tehranzadeh J, Gubernick I, Blaha D. Prospective study of sequential technetium-99m phosphate and gallium imaging in painful hip prostheses (comparison of diagnostic modalities). Clin Nucl Med. 1988;13:229-36.
80. Hill DS, Naim S, Powell RJ, Kinsella D, Toms AD, Howell J. 3-phase Technicium-99m bone scanning in patients with pain in the hip region after cemented total hip replacement: a multicentre series of 100 cases. Hip International. 28(3):259-265, 2018 May.
81. Nagoya S, Kaya M, Sasaki M, Tateda K, Yamashita T. Diagnosis of peri-prosthetic infection at the hip using triple-phase bone scintigraphy. J Bone Joint Surg Br. 2008;90:140-4.
82. Reinartz P, Mumme T, Hermanns B, et al. Radionuclide imaging of the painful hip arthroplasty: positron-emission tomography versus triple-phase bone scanning. J Bone Joint Surg Br. 2005;87:465-70.
83. Schweizer T, Schiapparelli FF, Rotigliano N, Rasch H, Amsler F, Hirschmann MT. Patterns of bone tracer uptake on SPECT-CT in symptomatic and asymptomatic patients with primary total hip arthroplasty. Eur J Nucl Med Mol Imaging. 45(2):283-291, 2018 Feb.
84. Cyteval C, Hamm V, Sarrabere MP, Lopez FM, Maury P, Taourel P. Painful infection at the site of hip prosthesis: CT imaging. Radiology. 2002;224:477-83.
85. Isern-Kebschull J, Tomas X, Garcia-Diez AI, et al. Value of multidetector computed tomography for the differentiation of delayed aseptic and septic complications after total hip arthroplasty. Skeletal Radiol. 49(6):893-902, 2020 Jun.
86. Chryssikos T, Parvizi J, Ghanem E, Newberg A, Zhuang H, Alavi A. FDG-PET imaging can diagnose periprosthetic infection of the hip. Clin Orthop Relat Res. 2008;466:1338-42.
87. Mumme T, Reinartz P, Alfer J, Muller-Rath R, Buell U, Wirtz DC. Diagnostic values of positron emission tomography versus triple-phase bone scan in hip arthroplasty loosening. Arch Orthop Trauma Surg. 2005;125:322-9.
88. Pill SG, Parvizi J, Tang PH, et al. Comparison of fluorodeoxyglucose positron emission tomography and (111)indium-white blood cell imaging in the diagnosis of periprosthetic infection of the hip. J Arthroplasty. 2006;21:91-7.
89. Verberne SJ, Temmerman OPP, Vuong BH, Raijmakers PG. Fluorodeoxyglucose positron emission tomography imaging for diagnosing periprosthetic hip infection: the importance of diagnostic criteria. Int Orthop. 42(9):2025-2034, 2018 09.
90. Zhuang H, Duarte PS, Pourdehnad M, et al. The promising role of 18F-FDG PET in detecting infected lower limb prosthesis implants. J Nucl Med. 2001;42(1):44-48.
91. Garcia-Barrecheguren E, Rodriguez Fraile M, Toledo Santana G, Valenti Nin JR, Richter Echevarria JA. [FDG-PET: a new diagnostic approach in hip prosthetic replacement]. Rev Esp Med Nucl. 2007;26(4):208-220.
92. Kiran M, Donnelly TD, Armstrong C, Kapoor B, Kumar G, Peter V. Diagnostic utility of fluorodeoxyglucose positron emission tomography in prosthetic joint infection based on MSIS criteria. Bone Joint J. 101-B(8):910-914, 2019 Aug.
93. Kwee RM, Broos WA, Brans B, Walenkamp GH, Geurts J, Weijers RE. Added value of 18F-FDG PET/CT in diagnosing infected hip prosthesis. Acta Radiol. 59(5):569-576, 2018 May.
94. Delank KS, Schmidt M, Michael JW, Dietlein M, Schicha H, Eysel P. The implications of 18F-FDG PET for the diagnosis of endoprosthetic loosening and infection in hip and knee arthroplasty: results from a prospective, blinded study. BMC Musculoskelet Disord. 2006;7:20.
95. Basu S, Kwee TC, Saboury B, et al. FDG PET for diagnosing infection in hip and knee prostheses: prospective study in 221 prostheses and subgroup comparison with combined (111)In-labeled leukocyte/(99m)Tc-sulfur colloid bone marrow imaging in 88 prostheses. Clin Nucl Med. 39(7):609-15, 2014 Jul.
96. Love C, Marwin SE, Tomas MB, et al. Diagnosing infection in the failed joint replacement: a comparison of coincidence detection18F-FDG and 111In-labeled leukocyte/99mTc-sulfur colloid marrow imaging. J Nucl Med. 2004;45(11):1864-1871.
97. Choe H, Inaba Y, Kobayashi N, et al. Use of 18F-fluoride PET to determine the appropriate tissue sampling region for improved sensitivity of tissue examinations in cases of suspected periprosthetic infection after total hip arthroplasty. Acta Orthop. 2011;82(4):427-432.
98. Kobayashi N, Inaba Y, Choe H, et al. Use of F-18 fluoride PET to differentiate septic from aseptic loosening in total hip arthroplasty patients. Clin Nucl Med. 36(11):e156-61, 2011 Nov.
99. Kumar R, Kumar R, Kumar V, Malhotra R. Comparative analysis of dual-phase 18F-fluoride PET/CT and three phase bone scintigraphy in the evaluation of septic (or painful) hip prostheses: A prospective study. J Orthop Sci. 21(2):205-10, 2016 Mar.
100. Kumar R, Kumar R, Kumar V, Malhotra R. Potential clinical implication of (18) F-FDG PET/CT in diagnosis of periprosthetic infection and its comparison with (18) F-Fluoride PET/CT. J Med Imaging Radiat Oncol. 60(3):315-22, 2016 Jun.
101. Perez-Prieto D, Hinarejos P, Alier A, et al. Adherence to a reliable PJI diagnostic protocol minimizes unsuspected positive cultures rate. BMC Musculoskelet Disord. 22(1):653, 2021 Aug 02.
102. Carli AV, Abdelbary H, Ahmadzai N, et al. Diagnostic Accuracy of Serum, Synovial, and Tissue Testing for Chronic Periprosthetic Joint Infection After Hip and Knee Replacements: A Systematic Review. J Bone Joint Surg Am 2019;101:635-49.
103. Li R, Li X, Ni M, Zheng QY, Zhang GQ, Chen JY. Anatomic Landmark-Guided Hip Aspiration in the Diagnosis of Periprosthetic Joint Infection. Orthopedics. 44(1):e85-e90, 2021 Jan 01.
104. Randelli F, Brioschi M, Randelli P, Ambrogi F, Sdao S, Aliprandi A. Fluoroscopy- vs ultrasound-guided aspiration techniques in the management of periprosthetic joint infection: which is the best?. Radiol Med (Torino). 123(1):28-35, 2018 Jan.
105. Tomas X, Bori G, Garcia S, et al. Accuracy of CT-guided joint aspiration in patients with suspected infection status post-total hip arthroplasty. Skeletal Radiol. 2011;40:57-64.
106. American Academy of Orthopaedic Surgeons. Diagnosis and Prevention of Periprosthetic Joint Infections. Clinical Practice Guideline on the Diagnosis and Prevention of Periprosthetic Joint Infections.  Available at: https://www.aaos.org/quality/quality-programs/tumor-infection-and-military-medicine-programs/diagnosis--prevention-of-periprosthetic-joint-infections/.
107. Plodkowski AJ, Hayter CL, Miller TT, Nguyen JT, Potter HG. Lamellated hyperintense synovitis: potential MR imaging sign of an infected knee arthroplasty. Radiology. 2013;266(1):256-260.
108. Albano D, Messina C, Zagra L, et al. Failed Total Hip Arthroplasty: Diagnostic Performance of Conventional MRI Features and Locoregional Lymphadenopathy to Identify Infected Implants. J Magn Reson Imaging. 53(1):201-210, 2021 01.
109. Galley J, Sutter R, Stern C, Filli L, Rahm S, Pfirrmann CWA. Diagnosis of Periprosthetic Hip Joint Infection Using MRI with Metal Artifact Reduction at 1.5 T. Radiology. 296(1):98-108, 2020 07.
110. Gao Z, Jin Y, Chen X, et al. Diagnostic Value of MRI Lamellated Hyperintense Synovitis in Periprosthetic Infection of Hip. Orthop Surg 2020;12:1941-46.
111. Schwaiger BJ, Gassert FT, Suren C, et al. Diagnostic accuracy of MRI with metal artifact reduction for the detection of periprosthetic joint infection and aseptic loosening of total hip arthroplasty. Eur J Radiol. 131:109253, 2020 Oct.
112. Aliprandi A, Sconfienza LM, Randelli F, Bandirali M, Di Leo G, Sardanelli F. Magnetic resonance imaging of painful total hip replacement: detection and characterisation of periprosthetic fluid collection and interobserver reproducibility. Radiol Med. 2012;117:85-95.
113. Weybright PN, Jacobson JA, Murry KH, et al. Limited effectiveness of sonography in revealing hip joint effusion: preliminary results in 21 adult patients with native and postoperative hips. AJR Am J Roentgenol 2003;181:215-8.
114. van Holsbeeck MT, Eyler WR, Sherman LS, et al. Detection of infection in loosened hip prostheses: efficacy of sonography. AJR Am J Roentgenol 1994;163:381-4.
115. Joseph TN, Mujtaba M, Chen AL, et al. Efficacy of combined technetium-99m sulfur colloid/indium-111 leukocyte scans to detect infected total hip and knee arthroplasties. J Arthroplasty. 2001 Sep;16(6):753-8.
116. Palestro CJ, Kim CK, Swyer AJ, Capozzi JD, Solomon RW, Goldsmith SJ. Total-hip arthroplasty: periprosthetic indium-111-labeled leukocyte activity and complementary technetium-99m-sulfur colloid imaging in suspected infection. J Nucl Med. 1990;31:1950-5.
117. Temmerman OP, Raijmakers PG, Berkhof J, et al. Diagnostic accuracy and interobserver variability of plain radiography, subtraction arthrography, nuclear arthrography, and bone scintigraphy in the assessment of aseptic femoral component loosening. Arch Orthop Trauma Surg. 2006;126:316-23.
118. Temmerman OP, Raijmakers PG, David EF, et al. A comparison of radiographic and scintigraphic techniques to assess aseptic loosening of the acetabular component in a total hip replacement. J Bone Joint Surg Am. 2004;86-A:2456-63.
119. Backer HC, Steurer-Dober I, Beck M, et al. Magnetic resonance imaging (MRI) versus single photon emission computed tomography (SPECT/CT) in painful total hip arthroplasty: a comparative multi-institutional analysis. Br J Radiol. 93(1105):20190738, 2020 Jan.
120. Berber R, Henckel J, Khoo M, et al. Clinical Usefulness of SPECT-CT in Patients with an Unexplained Pain in Metal on Metal (MOM) Total Hip Arthroplasty. J Arthroplasty. 30(4):687-94, 2015 Apr.
121. Blum A, Gondim-Teixeira P, Gabiache E, et al. Developments in imaging methods used in hip arthroplasty: A diagnostic algorithm. Diagn Interv Imaging. 97(7-8):735-47, 2016 Jul-Aug.
122. Kwak HS, Yoo JJ, Lee YK, Koo KH, Yoon KS, Kim HJ. The result of revision total hip arthroplasty in patients with metallosis following a catastrophic failure of a polyethylene liner. Clin. orthop. surg.. 7(1):46-53, 2015 Mar.
123. Kirkham JR, Petscavage JM, Richardson ML. Metallosis: CT findings in a total hip arthroplasty. Radiol Case Rep 2010;5:410.
124. Gillet R, Teixeira P, Bonarelli C, et al. Comparison of radiographs, tomosynthesis and CT with metal artifact reduction for the detection of hip prosthetic loosening. Eur Radiol. 29(3):1258-1266, 2019 Mar.
125. Puri L, Wixson RL, Stern SH, Kohli J, Hendrix RW, Stulberg SD. Use of helical computed tomography for the assessment of acetabular osteolysis after total hip arthroplasty. J Bone Joint Surg Am. 2002 Apr;84(4):609-14.
126. Walde TA, Weiland DE, Leung SB, et al. Comparison of CT, MRI, and radiographs in assessing pelvic osteolysis: a cadaveric study. Clin Orthop Relat Res. 2005:138-44.
127. Duffy PJ, Masri BA, Garbuz DS, Duncan CP. Evaluation of patients with pain following total hip replacement. J Bone Joint Surg Am 2005;87:2566-75.
128. Braunstein EM, Cardinal E, Buckwalter KA, Capello W. Bupivicaine arthrography of the post-arthroplasty hip. Skeletal Radiol 1995;24:519-21.
129. Maus TP, Berquist TH, Bender CE, Rand JA. Arthrographic study of painful total hip arthroplasty: refined criteria. Radiology. 1987;162:721-7.
130. Crawford RW, Ellis AM, Gie GA, Ling RS. Intra-articular local anaesthesia for pain after hip arthroplasty. J Bone Joint Surg Br 1997;79:796-800.
131. Hayter CL, Koff MF, Potter HG. Magnetic resonance imaging of the postoperative hip. J Magn Reson Imaging. 2012;35(5):1013-1025.
132. Burge AJ, Konin GP, Berkowitz JL, Lin B, Koff MF, Potter HG. What is the Diagnostic Accuracy of MRI for Component Loosening in THA? Clin Orthop Relat Res 2019;477:2085-94.
133. Potter HG, Nestor BJ, Sofka CM, Ho ST, Peters LE, Salvati EA. Magnetic resonance imaging after total hip arthroplasty: evaluation of periprosthetic soft tissue. J Bone Joint Surg Am. 2004;86-A(9):1947-1954.
134. Robinson E, Henckel J, Sabah S, Satchithananda K, Skinner J, Hart A. Cross-sectional imaging of metal-on-metal hip arthroplasties. Can we substitute MARS MRI with CT? Acta Orthop 2014;85:577-84.
135. Ovesen O, Riegels-Nielsen P, Lindequist S, et al. The diagnostic value of digital subtraction arthrography and radionuclide bone scan in revision hip arthroplasty. J Arthroplasty 2003;18:735-40.
136. von Knoch M, Barden B, Saxler G, Loer F. The diagnostic value of digital subtraction arthrography and radionuclide arthrography in revision total hip arthroplasty. Biomed Tech (Berl) 2004;49:351-5.
137. Kwon YM, Khormaee S, Liow MH, Tsai TY, Freiberg AA, Rubash HE. Asymptomatic Pseudotumors in Patients with Taper Corrosion of a Dual-Taper Modular Femoral Stem: MARS-MRI and Metal Ion Study. Journal of Bone & Joint Surgery - American Volume. 98(20):1735-1740, 2016 Oct 19.J Bone Joint Surg Am. 98(20):1735-1740, 2016 Oct 19.
138. Kwon YM, Rossi D, MacAuliffe J, Peng Y, Arauz P. Risk Factors Associated With Early Complications of Revision Surgery for Head-Neck Taper Corrosion in Metal-on-Polyethylene Total Hip Arthroplasty. J Arthroplasty. 33(10):3231-3237, 2018 10.
139. Padgett DE, Su EP, Wright TM, Burge AJ, Potter HG. How Useful Is Magnetic Resonance Imaging in Evaluating Adverse Local Tissue Reaction?. J Arthroplasty. 35(6S):S63-S67, 2020 06.
140. Mahajan J, Bonner B, Oganesyan R, Yeo I, Klemt C, Kwon YM. MARS MRI Characteristics of Adverse Local Tissue Reactions in Taper Corrosion of Metal-On-Polyethylene THA Differ From Metal-On-Metal THA. J Arthroplasty. 35(11):3338-3342, 2020 11.
141. Weber MA, Snyder MJ, Workman KK, et al. Comparison of Asymptomatic and Symptomatic Adverse Local Tissue Reaction in Patients With Head-Neck Taper Corrosion. J Arthroplasty. 36(7S):S358-S362, 2021 07.
142. Koff MF, Esposito C, Shah P, et al. MRI of THA Correlates With Implant Wear and Tissue Reactions: A Cross-sectional Study. Clin Orthop. 477(1):159-174, 2019 01.
143. Morozov PP, Sana M, McGrory BJ, Farraher SW, Abrahams TG. Comparison of Pre-Revision Magnetic Resonance Imaging and Operative Findings in Mechanically Assisted Crevice Corrosion in Symptomatic Metal-on-Polyethylene Total Hip Arthroplasties. J Arthroplasty. 32(8):2535-2545, 2017 08.
144. Robbins GM, Masri BA, Garbuz DS, Duncan CP. Evaluation of pain in patients with apparently solidly fixed total hip arthroplasty components. J Am Acad Orthop Surg 2002;10:86-94.
145. Shemesh SS, Moucha CS, Keswani A, Maher NA, Chen D, Bronson MJ. Trochanteric Bursitis Following Primary Total Hip Arthroplasty: Incidence, Predictors, and Treatment. J Arthroplasty 2018;33:1205-09.
146. Bremer AK, Kalberer F, Pfirrmann CW, Dora C. Soft-tissue changes in hip abductor muscles and tendons after total hip replacement: comparison between the direct anterior and the transgluteal approaches. J Bone Joint Surg Br 2011;93:886-9.
147. Pfirrmann CW, Notzli HP, Dora C, Hodler J, Zanetti M. Abductor tendons and muscles assessed at MR imaging after total hip arthroplasty in asymptomatic and symptomatic patients. Radiology. 2005;235(3):969-976.
148. Ylinen P, Tallroth K, Konttinen YT, Landtman M, Paavilainen T. Arthrography for the diagnosis of abductor avulsion after total hip arthroplasty: a comparison of arthrographic and surgical findings in 33 patients. Acta Orthop. 2007;78(3):340-343.
149. Bancroft LW, Blankenbaker DG. Imaging of the tendons about the pelvis. AJR Am J Roentgenol. 2010;195(3):605-617.
150. Garcia FL, Picado CH, Nogueira-Barbosa MH. Sonographic evaluation of the abductor mechanism after total hip arthroplasty. J Ultrasound Med. 2010;29(3):465-471.
151. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/Clinical/Appropriateness-Criteria/ACR-Appropriateness-Criteria-Radiation-Dose-Assessment-Introduction.pdf.
Disclaimer
The ACR Committee on Appropriateness Criteria and its expert panels have developed criteria for determining appropriate imaging examinations for diagnosis and treatment of specified medical condition(s). These criteria are intended to guide radiologists, radiation oncologists and referring physicians in making decisions regarding radiologic imaging and treatment. Generally, the complexity and severity of a patient’s clinical condition should dictate the selection of appropriate imaging procedures or treatments. Only those examinations generally used for evaluation of the patient’s condition are ranked.  Other imaging studies necessary to evaluate other co-existent diseases or other medical consequences of this condition are not considered in this document.  The availability of equipment or personnel may influence the selection of appropriate imaging procedures or treatments. Imaging techniques classified as investigational by the FDA have not been considered in developing these criteria; however, study of new equipment and applications should be encouraged.  The ultimate decision regarding the appropriateness of any specific radiologic examination or treatment must be made by the referring physician and radiologist in light of all the circumstances presented in an individual examination