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SPECT-CT may help identify cause of unexplained pain after MOM hip arthroplasty
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Recently published data demonstrated single photon emission tomography / CT can be a useful part of the treatment algorithm for identifying the cause of pain in patients with unexplained pain after undergoing metal-on-metal hip arthroplasty.
Researchers identified 19 prosthetic metal-on-metal (MOM) hips in 15 patients (median age: 53 years) with unexplainable causes of pain before and after single photon emission tomography / CT (SPECT-CT), comparing the diagnosis and management plan for each patient.
Using a chi-square test, the researchers assessed the utility of SPECT-CT to establish whether SPECT-CT data changed the diagnosis and / or treatment of patients’ pain after MOM hip arthroplasty.
According to the researchers, SPECT-CT was useful for all patients, with changes in clinical management decisions made in 13 of the 19 patients with unexplained pain. The other six patients continued to have unexplained pain, but SPECT-CT confirmed the initial non-operative treatment plan should be continued.
Following SPECT-CT, loosening was observed in three femoral stems and one acetabular cup. The four patients were advised to revision surgery.
One patient had evidence of intracapsular joint fluid on the MRI, even though SPECT-CT was normal; therefore, local anesthetic hip injection was used to relieve the pain, and the patient was recommended for hip revision.
The researchers concluded SPECT-CT should be reserved as a specialist test in cases where conventional investigations fail to identify potential causes of pain. ‒ by Monica Jaramillo
Disclosures: Berber reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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