Sofka Carolyn M
Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY 10021, USA.
Skeletal Radiol. 2007 Mar;36(3):183-93. doi: 10.1007/s00256-006-0226-x. Epub 2006 Dec 6.
Patients with a painful arthroplasty can present a clinical diagnostic dilemma. Aspirates are often negative for infection and alignment of the prosthesis on conventional radiographs is usually satisfactory. These patients can have a myriad of soft tissue as well as osseous pathologies, which may be clinically unsuspected or radiographically occult. The ability of advanced cross-sectional imaging to diagnose osseous and soft tissue injuries has been well documented, but applications to arthroplasty imaging are often limited by regional metallic artifacts. Adjustment of standard imaging parameters can make CT and MR imaging useful adjuncts in imaging the painful arthroplasty, especially in the setting of normal radiographs. Ultrasound can be used to evaluate the periprosthetic soft tissues and provide a real-time method of evaluating the dynamic relationship of the periprosthetic soft tissues to the arthroplasty components, and it also can be used as a guide for diagnostic and therapeutic interventions.
接受关节置换术的患者出现疼痛时，临床诊断可能会陷入两难境地。抽吸物通常未检测出感染，且传统X线片上假体的对线情况通常令人满意。这些患者可能存在多种软组织及骨病变，临床上可能未被怀疑，或在影像学上隐匿不显。先进的断层成像技术诊断骨与软组织损伤的能力已有充分记录，但在关节置换术成像中的应用常受局部金属伪影限制。调整标准成像参数可使CT和MR成像成为疼痛性关节置换术成像的有用辅助手段，尤其是在X线片正常的情况下。超声可用于评估假体周围软组织，并提供一种实时评估假体周围软组织与关节置换部件动态关系的方法，还可作为诊断和治疗干预的引导手段。
