Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Hip
Abstract number: 23403
USE OF ULTRASOUND IN DIAGNOSIS OF ADVERSE REACTIONS TO METAL
DEBRIS (ARMD) FOLLOWING METAL ON METAL HIP REPLACEMENT
Kiran SINGISETTI, P RAJU, A NARGOL
University Hospital of North Tees, Stockton on Tees (UNITED KINGDOM)
INTRODUCTION: Persisting groin pain following a metal-on-metal hip replacement
can be due to several causes. A detailed clinical examination and investigations are
required to evaluate the cause of such pain. METHODS: We describe our experience
with 25 patients of large metal on metal hip replacements presenting with groin pain,
where ultrasound proved to be a useful diagnostic tool. RESULTS: Ultrasound
proved to be useful in diagnosis of iliopsoas bursitis, trochanteric bursitis, adductor
tendonitis, femoral hernia and fluid collections as the cause of pain following metal on
metal hip arthroplasty. Floating echogenic reflections and large cystic swellings were
diagnosed as suggestive of Adverse Reactions to Metal Debris (ARMD) or ALVAL
(aseptic lymphocytic vasculitis associated lesions). These cases were later confirmed
by histological examination.
DISCUSSION: Ultrasound is a cheap, non-invasive and dynamic study which can be
used as a diagnostic tool to diagnose groin pain following metal on metal hip
replacements.
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