MRI of aseptic lymphocytic vasculitis-associated lesions in metal-on-metal hip replacements

AJR Am J Roentgenol. 2012 Jun;198(6):1394-402. doi: 10.2214/AJR.11.7504.

Abstract

Objective: The aim of this review is to describe the clinical, histopathologic, and MRI features of aseptic lymphocytic vasculitis-associated lesions in total hip replacements.

Conclusion: The introduction of modern metal-on-metal hip arthroplasty has been accompanied by a newly described disease, aseptic lymphocytic vasculitis-associated lesions, which is characterized histologically by bland necrosis and dense perivascular lymphocytic infiltrates. Conventional radiographic findings are often normal, but the typical MRI findings include periprosthetic fluid collections, soft-tissue masses, gluteal tendon avulsion, bone loss, periosteal stripping, neurovascular involvement, and periprosthetic fractures. The severity of the histologic and MRI appearances can be graded according to defined published criteria.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip*
  • Female
  • Hip Prosthesis*
  • Humans
  • Lymphocytes
  • Magnetic Resonance Imaging / methods*
  • Male
  • Metals
  • Middle Aged
  • Postoperative Complications / diagnosis*
  • Prosthesis Failure
  • Severity of Illness Index
  • Vasculitis / diagnosis*

Substances

  • Metals