Table 1 Combined SPECT/CT criteria for the assessment of loosening of uncemented hip prostheses
From: Hybrid SPECT/CT for the assessment of a painful hip after uncemented total hip arthroplasty
SPECT | CT | ||
|---|---|---|---|
A - Acetabular component | 1 - Normal | No increased uptake | No radiolucency, no osteolysis |
2 - Physiological remodeling | Increased uptake of surrounding bone at the superior and/or inferior third of the cup | No radiolucency or osteolysis in areas corresponding to SPECT findings (differentiation of surrounding bone and prosthesis-bone interface) | |
3 - Pathological loosening | 1 - Increased uptake of the whole prosthesis-bone interface | Possibly radiolucency or osteolysis at the prosthesis-bone interface | |
2 - Increased uptake of the intermediate third in combination with the inferior or superior third | Possibly radiolucency at the prosthesis-bone interface | ||
3 - Increased uptake in the superior or inferior third of the component | In combination with a radiolucent line or osteolysis in the area corresponding to SPECT findings | ||
F - Femoral component | 1 - Normal | No increased uptake | No radiolucency, no osteolysis |
2 - Physiological remodeling | 1 - Increased uptake at the prosthesis-dependent zones not crucial for fixation | Possibly radiolucency at the prosthesis-bone interface, no radiolucency or osteolysis at crucial fixation zones | |
2 - Increased uptake of surrounding bone at the crucial fixation zones | No radiolucency or osteolysis in corresponding areas (differentiation of surrounding bone and prosthesis-bone interface) | ||
3 - Pathological loosening | 1 - Increased uptake of the whole prosthesis-bone interface | Possibly radiolucency or osteolysis at the prosthesis-bone interface | |
2 - Multifocal uptake with at least one focus within the crucial fixation zone of the prosthesis | Possibly radiolucency or osteolysis at the prosthesis-bone interface |