Metallosis and Metal-Induced Synovitis Following Total Knee Arthroplasty: Review of Radiographic and CT Findings

Authors

  • Jason W Romesburg
  • Paul L Wasserman
  • Candace H Schoppe

DOI:

https://doi.org/10.3941/jrcr.v4i9.423

Keywords:

Metallosis, metal-induced synovitis, total knee arthroplasty complications, polyethylene liner failure, periprosthetic osteolysis, bubble sign, metal-line sign, cloud sign

Abstract

Metallosis and metal-induced synovitis are well-recognized complications of metal-backed polyethylene joint prostheses and have been frequently described in the orthopedic surgery literature; however, relatively fewer articles discussing the radiologic aspects of this complication have been published.  To illustrate the importance of radiologic findings in the diagnosis and management of these patients, we present a case of metallosis and metal-induced synovitis complicating two revisions of a total knee arthroplasty, caused by polyethylene liner wear and dissociation of the polyethylene liner from the metal-backed patellar prosthesis.  Specific attention is given to reviewing signs that aid in diagnosis, such as the "bubble sign," "cloud sign," and "metal-line signs."

Author Biographies

Jason W Romesburg

Radiology resident, Wake Forest Univeristy Baptist Medical Center

Paul L Wasserman

Assistant Professor, Radiology, Musculoskeletal Imaging

Candace H Schoppe

Pathology resident, Wake Forest University Baptist Medical Center
Metallosis and Metal-Induced Synovitis Following Total Knee Arthroplasty: Review of Radiographic and CT Findings by Romesburg et al.

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Published

2010-09-01

Issue

Vol. 4 No. 9 (2010)

Section

Musculoskeletal Radiology

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