Catherine Lee Hayter1, Hollis G. Potter1,2, Douglas E. Padgett3, Giorgio Perino4, Bryan J. Nestor3
1Department of Radiology & Imaging, Hospital for Special Surgery, New York, NY, USA; 2Weill Cornell Medical College of Cornell University, New York, NY, USA; 3Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA; 4Department of Pathology, Hospital for Special Surgery, New York, NY, USA
This study assessed the ability of MRI to detect different qualitative patterns of synovitis in symptomatic patients with hip arthroplasty compared to asymptomatic controls. We hypothesized a distinct, qualitative synovial MRI pattern would exist for metal on metal wear, metal on polymeric debris and aseptic lymphocytic vasculitis-associated lesions (ALVAL), that would be concordant with histologic findings. MRI could distinguish between tissue containing particulate debris and tissue without debris. MRI was sensitive in detecting polymeric debris, but did not detect the presence of metal in all samples. ALVAL elicited a specific synovial pattern on MRI that was highly concordant with histology.