Seminars in Nuclear Medicine
Volume 39, Issue 1 , Pages 66-78 , January 2009

Nuclear Medicine and the Infected Joint Replacement

  • Charito Love, MD

      Affiliations

    • Division of Nuclear Medicine and Molecular Imaging, North Shore Long Island Jewish Health System, New Hyde Park, NY
  • ,
  • Scott E. Marwin, MD

      Affiliations

    • Department of Surgery (Orthopedic Surgery), Albert Einstein College of Medicine of Yeshiva University, Bronx, NY
    • Department of Orthopedic Surgery, North Shore Long Island Jewish Health System, New Hyde Park, NY
  • ,
  • Christopher J. Palestro, MD

      Affiliations

    • Division of Nuclear Medicine and Molecular Imaging, North Shore Long Island Jewish Health System, New Hyde Park, NY
    • Department of Nuclear Medicine and Radiology, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY
    • Corresponding Author InformationAddress reprint requests to Christopher J. Palestro, MD, Division of Nuclear Medicine and Molecular Imaging, Long Island Jewish Medical Center, 270-05 76th Avenue, New Hyde Park, NY 11040

References 

  1. Love C, Tomas MB, Marwin SE, et al. Role of nuclear medicine in diagnosis of the infected joint replacement. RadioGraphics. 2001;21:1229–1238
  2. Maloney WJ, Smith RL. Periprosthetic osteolysis in total hip arthroplasty: The role of particulate wear debris. J Bone Joint Surg [Am]. 1995;77-A:1448–1461
  3. Kurtz S, Ong K, Lau E, et al. Projections of primary and revision hip and knee arthroplasty in the United States from 2005-2030. J Bone Joint Surg [Am]. 2007;89-A:780–785
  4. Ostlere S, Soin S. Imaging of prosthetic joints. Imaging. 2003;15:270–285
  5. Bauer TW, Schils J. The pathology of total joint arthroplasty (II. Mechanisms of implant failure). Skeletal Radiol. 1999;28:483–497
  6. Wooley PH, Nasser S, Fitzgerald RH. The immune response to implant materials in humans. Clin Orthop. 1996;326:63–70
  7. Toumbis CA, Kronick JL, Wooley PH, et al. Total joint arthroplasty and the immune response. Semin Arthritis Rheum. 1997;27:44–47
  8. Spector M, Shortkroff S, Hsu HP, et al. Tissue changes around loose prostheses: A canine model to investigate the effects of anti-inflammatory agent. Clin Orthop. 1990;261:140–152
  9. Pandey R, Drakoulakis E, Athanasou NA. An assessment of the histologic criteria used to diagnose infection in hip revision arthroplasty tissues. J Clin Pathol. 1999;52:118–123
  10. Hanssen AD, Rand JA. Evaluation and treatment of infection at the site of a total hip or knee arthroplasty. J Bone J Surg [Am]. 1998;80-A:910–922
  11. Palestro CJ, Love C, Miller TT. Imaging of musculoskeletal infections. Best Pract Res Clin Rheumatol. 2006;20:1197–1218
  12. Gelman MI, Coleman RE, Stevens PM, et al. Radiography, radionuclide imaging, and arthrography in the evaluation of total hip and knee replacement. Radiology. 1978;128:677–682
  13. Weiss PE, Mall JC, Hoffer PB, et al. 99mTc-methylenediphosphonate bone imaging in the evaluation of total hip prostheses. Radiology. 1979;133:727–729
  14. Williamson BRJ, McLaughlin RE, Wang GJ, et al. Radionuclide bone imaging as a means of differentiating loosening and infection in patients with a painful total hip prosthesis. Radiology. 1979;133:723–726
  15. Williams F, McCall IW, Park WM, et al. Gallium-67 scanning in the painful total hip replacement. Clin Radiol. 1981;32:431–439
  16. Mountford PJ, Hall FM, Wells CP, et al. 99Tcm-MDP, 67Ga-citrate and 111In-leucocytes for detecting prosthetic hip infection. Nucl Med Commun. 1986;7:113–120
  17. Aliabadi P, Tumeh SS, Weissman BN, et al. Cemented total hip prosthesis: Radiographic and scintigraphic evaluation. Radiology. 1989;173:203–206
  18. Lieberman JR, Huo MH, Schneider R, et al. Evaluation of painful hip arthroplasties. J Bone Joint Surg [Br]. 1993;75-B:475–478
  19. Utz JA, Lull RJ, Galvin EG. Asymptomatic total hip prosthesis: Natural history determined using Tc-99m MDP bone scans. Radiology. 1986;161:509–512
  20. Oswald SG, Van Nostrand D, Savory CG, et al. 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;30:1321–1331
  21. Oswald SG, Van Nostrand D, Savory CG, et al. The acetabulum: a prospective study of three-phase bone and indium white blood cell scintigraphy following porous-coated hip arthroplasty. J Nucl Med. 1990;31:274–280
  22. Ashbrooke AB, Calvert PT. Bone scan appearances after uncemented hip replacement. J Royal Soc Med. 1990;83:768–769
  23. Rosenthall L, Lepanto L, Raymond F. Radiophosphate uptake in asymptomatic knee arthroplasty. J Nucl Med. 1987;28:1546–1549
  24. Hofmann AA, Wyatt RWB, Daniels AU, et al. Bone scans after total knee arthroplasty in asymptomatic patients. Clin Orthop. 1990;251:183–188
  25. Palestro CJ, Swyer AJ, Kim CK, et al. Infected knee prostheses: Diagnosis with In-111 leukocyte, Tc-99m sulfur colloid, and Tc-99m MDP imaging. Radiology. 1991;179:645–648
  26. Love C, Tronco GG, Yu AK, et al. Diagnosing lower extremity (LE) prosthetic joint infection: Bone, gallium & labeled leukocyte imaging. Presented at the 2008 SNM Meeting, New Orleans, LA, June 14-18 2008;
  27. Magnuson JE, Brown ML, Hauser MF, et al. In-111 labeled leukocyte scintigraphy in suspected orthopedic prosthesis infection: Comparison with other imaging modalities. Radiology. 1988;168:235–239
  28. Levitsky KA, Hozack WJ, Balderston RA, et al. Evaluation of the painful prosthetic joint (Relative value of bone scan, sedimentation rate, and joint aspiration). J Arthroplasty. 1991;6:237–244
  29. Reing CM, Richin PF, Kenmore PI. Differential bone-scanning in the evaluation of a painful total joint replacement. J Bone Joint Surg [Am]. 1979;61-A:933–936
  30. Rushton N, Coakley AJ, Tudor J, et al. The value of technetium and gallium scanning in assessing pain after total hip replacement. J Bone Joint Surg [Br]. 1982;64-B:313–318
  31. McKillop JH, McKay I, Cuthbert GF, et al. Scintigraphic evaluation of the painful prosthetic joint: A comparison of gallium-67 citrate and indium-111 labelled leukocyte imaging. Clin Radiol. 1984;35:239–241
  32. Palestro CJ. The current role of gallium imaging in infection. Semin Nucl Med. 1994;24:128–141
  33. 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;13:229–236
  34. Merkel KD, Fitzgerald RH Jr, Brown ML: Scintigraphic examination of total hip arthroplasty: comparison of indium with technetium-gallium in the loose and infected canine arthroplasty, in Welch RB (ed): The Hip. Proceedings of the Twelfth Open Scientific Meeting of the Hip Society, Atlanta, GA, 1984, pp 163-192
  35. Merkel KD, Brown ML, Fitzgerald RH. Sequential technetium-99m HMDP-gallium-67 citrate imaging for the evaluation of infection in the painful prosthesis. J Nucl Med. 1986;27:1413–1417
  36. Gomez-Luzuriaga MA, Galan V, Villar JM. Scintigraphy with Tc, Ga and In in painful total hip prostheses. Int Orthop. 1988;12:163–167
  37. Kraemer WJ, Saplys R, Waddell JP, et al. Bone scan, gallium scan, and hip aspiration in the diagnosis of infected total hip arthroplasty. J Arthroplasty. 1993;8:611–615
  38. Propst Proctor SL, Dillingham MF, McDougall IR, et al. The white blood cell scan in orthopedics. Clin Orthop. 1982;168:157–165
  39. Pring DJ, Henderson RG, Keshavarzian A, et al. Indium-granulocyte scanning in the painful prosthetic joint. AJR Am J Roentgenol. 1986;146:167–172
  40. Wukich DK, Abreu SH, Callaghan JJ, et al. Diagnosis of infection by preoperative scintigraphy with indium-labeled white blood cells. J Bone Joint Surg [Am]. 1987;69-A:1353–1360
  41. Johnson JA, Christie MJ, Sandler MP, et al. Detection of occult infection following total joint arthroplasty using sequential technetium-99m HDP bone scintigraphy and indium-111 WBC imaging. J Nucl Med. 1988;29:1347–1353
  42. Palestro CJ, Kim CK, Swyer AJ, et al. Total hip arthroplasty: periprosthetic indium-111-labeled leukocyte activity and complementary technetium-99m-sulfur colloid imaging in suspected infection. J Nucl Med. 1990;31:1950–1955
  43. Fineman D, Palestro CJ, Kim CK, et al. Detection of abnormalities in febrile AIDS patients with In-111-labeled leukocyte and GA-67 scintigraphy. Radiology. 1989;170:677–680
  44. Palestro CJ, Torres MA. Radionuclide imaging in orthopedic infections. Semin Nucl Med. 1997;27:334–345
  45. Palestro CJ, Mehta HH, Patel M, et al. Marrow versus infection in the Charcot joint: Indium-111 leukocyte and technetium-99m sulfur colloid scintigraphy. J Nucl Med. 1998;39:346–350
  46. Torres MA, Palestro CJ. Leukocyte-marrow scintigraphy in hyperostosis frontalis interna. J Nucl Med. 1997;38:1283–1285
  47. Palestro CJ, Kim CK, Vega A, et al. Acute effects of radiation therapy on indium-111-labeled leukocyte uptake in bone marrow. J Nucl Med. 1989;30:1989–1991
  48. Palestro CJ, Love C, Tronco GG, et al. Combined labeled leukocyte and technetium-99m sulfur colloid marrow imaging for diagnosing musculoskeletal infection: principles, technique, interpretation, indications and limitations. RadioGraphics. 2006;26:859–870
  49. Mulamba L'AH, Ferrant A, Leners N, et al. Indium-111 leucocyte scanning in the evaluation of painful hip arthroplasty. Acta Orthop Scand. 1983;54:695–697
  50. Love C, Marwin SE, Tomas MB, et al. Diagnosing infection in the failed joint replacement: a comparison of coincidence detection fluorine-18 FDG and indium-111-labeled leukocyte/technetium-99m-sulfur colloid marrow imaging. J Nucl Med. 2004;45:1864–1871
  51. 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;21:91–97
  52. Joseph TN, Mujitaba 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;16:753–758
  53. Pelosi E, Baiocco C, Pennone M, et al. 99mTc-HMPAO-leukocyte scintigraphy in patients with symptomatic total hip or knee arthroplasty: improved diagnostic accuracy by means of semiquantitative evaluation. J Nucl Med. 2004;45:438–444
  54. Zhuang H, Duarte PS, Pourdehnad M, et al. The promising role of 18F-FDG PET in detecting infected lower limb prosthesis implants. J Nuc Med. 2001;42:44–48
  55. Chacko TK, Zhuang H, Stevenson K, et al. The importance of the location of fluorodeoxyglucose uptake in periprosthetic infection in painful hip prostheses. Nucl Med Commun. 2002;23:851–855
  56. 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-B:465–470
  57. Manthey N, Reinhard P, Moog F, et al. The use of [18F] fluorodeoxyglucose positron emission tomography to differentiate between synovitis, loosening and infection of hip and knee prostheses. Nucl Med Commun. 2002;23:645–653
  58. 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;231:333–341

PII: S0001-2998(08)00104-9

doi: 10.1053/j.semnuclmed.2008.08.007

Seminars in Nuclear Medicine
Volume 39, Issue 1 , Pages 66-78 , January 2009