Ghozlan R, Massare C, Dupuis M
Rev Rhum Mal Osteoartic. 1986 Feb;53(2):93-6.
The authors propose a simple routine survey to be performed in the case of a painful total hip prosthesis which is generally able to define the diagnosis and the prognosis. X-ray films are more valuable by their repetition than by their simple analysis. Certain minor signs can help predict or detect loosening of the prosthesis or other complications, but in the great majority of cases, radiology alone is not sufficient to make the diagnosis, as the films are only able to show clear spaces around the prosthesis, without being able to definitely confirm the aetiopathogenic significance of this sign. In these cases, when the decision has not been taken to re-operate, more sophisticated investigations are required (scintigraphy, dynamic tests, arthrography), although they must be used with caution as very often the clinical findings will have the last word.
作者提出,对于疼痛的全髋关节假体病例,应进行一项简单的常规检查,该检查通常能够明确诊断和预后。X线片多次检查比单次简单分析更有价值。某些细微迹象有助于预测或检测假体松动或其他并发症,但在绝大多数情况下,仅靠放射学检查不足以做出诊断,因为X线片只能显示假体周围的透亮区,无法明确证实该征象的病因学意义。在这些尚未决定再次手术的病例中,需要进行更复杂的检查(闪烁扫描、动态试验、关节造影),不过使用这些检查时必须谨慎,因为很多时候临床结果才是最终定论。