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Despite improved strategies to prevent prosthetic joint infection, as the total number of joint replacements increases, so does the absolute number of infections. Radiography serves as the first-line imaging modality for the assessment of a suspected prosthetic joint infection. Additionally, serial radiographs acquired after a surgery to eradicate a prosthetic joint infection are an important clinical tool. Prosthetic joint infections are often treated with a 2-stage replacement arthroplasty utilizing a prosthesis with antibiotic-loaded acrylic cement. While complications are uncommon with this procedure, imaging may demonstrate periprosthetic fractures, as well as spacer migration, joint dislocation, and spacer fracture. We describe the classification of prosthetic joint infections, the clinical and imaging diagnosis, and treatment strategies. Familiarity with the hardware utilized in the management of the prosthetic joint infection, and its potential complications is fundamental to accurate imaging interpretation. [ABSTRACT FROM AUTHOR]

Glenohumeral osteoarthritis is a prevalent degenerative disease that can lead to excruciating pain and debility. End-stage osteoarthritis can be treated by both conservative and surgical interventions. Along with a comprehensive history and physical exam, pre-operative imaging with plain radiographs, computerized tomography, and magnetic resonance imaging plays an essential role in the decision-making process guiding whether the patient undergoes a shoulder hemiarthroplasty, anatomic total shoulder arthroplasty, or a reverse total shoulder arthroplasty. The most important pre-operative imaging factors are the integrity of the rotator cuff and presence of significant glenoid erosion. Imaging is also critical postoperatively, as signs of prosthetic loosening, rotator cuff failure (especially involving the subscapularis), periprosthetic fracture, and stress fractures are important entities to recognize. This article will review pertinent imaging findings related to the pre- and post-operative management of patients with glenohumeral osteoarthritis. [ABSTRACT FROM AUTHOR]

Objective: Cuff tear arthropathy (CTA) head prosthesis has recently become an alternative to standard shoulder hemiarthroplasty in patients with severe cuff disease by offering an increased surface area and decreased impingement. The purpose of this study is to evaluate the radiographic outcomes of CTA prosthesis and to correlate them with clinical outcomes.Materials and Methods: In this retrospective study of CTA hemiarthroplasties over an 11-year period, two radiologists reviewed pre-/postoperative radiographs and clinical data. Radiographic complications were correlated with subsequent surgery using Cox regression models. Rates of surgical revision and radiographic complications over time were estimated using Kaplan-Meier curves.Results: Ninety-seven CTA hemiarthroplasties were identified in 92 patients (5 bilateral) with a mean patient age of 68.7 years. Mean radiographic follow-up was 12 months with a mean of 3.3 radiographs per prosthesis. Twenty-six arthroplasties (26.8%) experienced at least one radiographic complication, including acromion remodeling (19.5%), anterior-posterior subluxation (5.2%), periprosthetic fracture (4.1%), glenoid remodeling (3.1%), hardware loosening (2.1%), superior subluxation (2.1%), and subsidence (1.0%). Eight cases underwent revision surgery (8.2%). The occurrence of a postoperative radiographic complication was associated with increased risk of surgical revision (hazard ratio 11.5, 95% CI: 2.4-55.7, p = 0.002); 73.5% of radiographic complications occurred by 3 months after the initial surgery (complication rate of 23.3%) based on Kaplan-Meier curve analysis.Conclusion: Radiographic complications after CTA head hemiarthroplasty are common with most occurring by 3 months after surgery and are highly associated with surgical revision. [ABSTRACT FROM AUTHOR]

The article presents abstracts on skeletal radiology including "What does matter for bone marrow adipose tissue: quantity or quality?," by Jamilly G.Maciel and colleagues, "Effects of radiation therapy onMRI textural features in sacral chordomas," by Ivan R. B.Godoy and colleagues, and "Cuff tear arthropathy shoulder hemiarthroplasty: a radiographic outcome study," by Alan S Leung and colleagues.

Although polyethylene wear-induced osteolysis is a common complication of hip arthroplasty, extensile osteolysis developing into a large granulomatous thigh mass at a site distant from the joint is rare. We report a case of a thigh pseudotumor 25 years after cemented bipolar hemiarthroplasty, in which x-rays revealed a radiolucent line around the stem at the proximal site only, not at the diaphysis of the femur. We initially suspected a real tumor because it had a unique appearance, as if the mass resorbed the posterior cortex of the femur, and it was located at a site distant from the proximal osteolytic lesions. We clearly showed the existence of a connection between the thigh mass and the joint space by performing intra-articular injection of contrast medium with continuous pressure. It seemed that polyethylene wear particles were transported distally along the stem-cement interface by fluid pressure, and an osteolytic reaction against polyethylene wear particles had occurred at the posterior middle third of the stem where the cement mantle was nonuniform and polyethylene particles first came into contact with the bone. Our findings suggest that nonuniform cemented prosthesis with osteolysis, even if it is low grade in a limited area, carries the risk of extensile osteolysis with asymptomatic development of an extra-articular granulomatous mass. [ABSTRACT FROM AUTHOR]

2 a Pelvic radiograph; b right hip radiograph Graph: Fig. An 85 year old female patient with known locally advanced adenocarcinoma of the lung of mucinous sub-type sustains a traumatic proximal femoral fracture following a low energy fall and undergoes hip hemiarthroplasty. [Extracted from the article]