Improving the detection of acetabular osteolysis using oblique radiographs

J Bone Joint Surg Br. 1999 Mar;81(2):289-95. doi: 10.1302/0301-620x.81b2.9334.

Abstract

Visualisation of periacetabular osteolysis by standard anteroposterior (AP) radiographs underestimates the extent of bone loss around a metal-backed acetabular component. We have assessed the effectiveness of standard radiological views in depicting periacetabular osteolysis, and recommend additional projections which make these lesions more visible. This was accomplished using a computerised simulation of radiological views and a radiological analysis of simulated defects placed at regular intervals around the perimeter of a cadaver acetabulum. The AP view alone showed only 38% of the defects over all of the surface of the cup and failed to depict a 3 mm lesion over 83% of the cup. When combined with the AP view, additional 45 degree obturator-oblique and iliac-oblique projections increased the depiction, showing 81% of the defects. The addition of the 60 degree obturator-oblique view further improved the visualisation of posterior defects, increasing the rate of detection to 94%. Based on this analysis, we recommend using at least three radiographic views when assessing the presence and extent of acetabular osteolysis.

MeSH terms

  • Acetabulum / diagnostic imaging*
  • Aged
  • Cadaver
  • Computer Simulation
  • Diagnosis, Computer-Assisted
  • Female
  • Hip Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Osteolysis / diagnostic imaging*
  • Radiography