Medical imaging diagnosis of orthopedic prosthesis-associated infections: a narrative review

Background and objective: Orthopedic prostheses have become increasingly prevalent in clinical practice in recent years. However, orthopedic prosthesis-associated infections (OPAI) have emerged as a serious complication associated with their use. Due to the variety of orthopedic implant types and the atypical clinical manifestations of OPAI, it is easy to cause delayed diagnosis and affect the prognosis of patients. The objective of this paper is to: (I) identify the potential imaging tools available to diagnose OPAI; (II) summarize the mechanisms and features by which each imaging modality can or cannot identify infection.

Methods: All the published papers were obtained from PubMed and Web of Science Core Collection on 1 February 2024. The study included original articles and reviews published in English between 2014 and 2024. EndNote was used to remove duplicates. Two independent authors conducted a comprehensive review of the titles and abstracts of the remaining literature to assess their eligibility for inclusion. Following this initial screening, the authors meticulously analyzed the abstracts and examined the full texts to confirm their suitability for final inclusion.

Key content and findings: A total of 55 articles were finally included for this narrative review. This review mainly summarized and analyzed the diagnostic value of ultrasound (US), X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine for OPAI, evaluated the advantages and disadvantages of each imaging technology, and tried to illuminate the future direction of diagnostic imaging methods development in this field.

Conclusions: Medical imaging has gained multidisciplinary recognition in the diagnosis of OPAI. Currently, there is an urgent need to establish large-scale, multicenter research projects. It is worth noting the key role of nuclear medicine diagnostic techniques and their unique metabolic information in the diagnosis of OPAI.