Radiographic and CT features of metallosis in a lame dog after total hip replacement: the cloud sign

Vet Radiol Ultrasound. 2024 Jan;65(1):49-53. doi: 10.1111/vru.13322. Epub 2023 Dec 22.

Abstract

A 2-year-old female American Akita was referred for CT of the pelvis and hindlimbs due to a left hindlimb lameness after a left total hip replacement. Referral radiographs and CT images demonstrated amorphous soft-tissue and mineral opacities surrounding the proximal femur and the prosthetic stem, consistent with the "cloud sign" reported as a characteristic of metallosis in humans. Dorsomedial displacement of the prosthetic head, multiple foci of geographic osteolysis alongside the "cloud sign", presumed pseudotumor lesions, and medial iliac lymphadenopathy were also identified with CT. Metallosis was confirmed based on ultrasound-guided cytology, revision surgery, and histopathology.

Keywords: bubble sign; hip dysplasia; postoperative complication.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Arthroplasty, Replacement, Hip* / adverse effects
  • Arthroplasty, Replacement, Hip* / veterinary
  • Dog Diseases* / diagnostic imaging
  • Dog Diseases* / etiology
  • Dog Diseases* / surgery
  • Dogs
  • Female
  • Femur
  • Hip Prosthesis* / adverse effects
  • Hip Prosthesis* / veterinary
  • Prosthesis Failure
  • Tomography, X-Ray Computed / veterinary