Improving the detection of acetabular osteolysis using oblique radiographs

D. G. Southwell, J. E. Bechtold*, W. D. Lew, A. H. Schmidt

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

53 Scopus citations

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°obturator-oblique and iliac-oblique projections increased the depiction, showing 81% of the defects. The addition of the 60°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.

Original languageEnglish
Pages (from-to)289-295
Number of pages7
JournalJournal of Bone and Joint Surgery - Series B
Volume81
Issue number2
DOIs
StatePublished - Mar 1999
Externally publishedYes

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