Imaging evaluation of periprosthetic loosening: A primer for the general radiologist

Figure 1 Subsidence of a loose femoral component in a revision total hip arthroplasty. The above case showcases the utilisation of plain radiography in the diagnosis of aseptic loosening. This patient had presented to the outpatient’s clinic 1 year following revision total hip arthroplasty with complaints of right sided hip pain that was gradually worsening. The revision surgery utilised a diaphyseal bearing modular revision system with cerclage cables for closure of the proximal femoral osteotomy as a result of periprosthetic fracture. A–C: Immediate postoperative (A) and 1-year postoperative (B) plain radiographs are displayed with significant subsidence of the femoral component noted in the follow-up appointment. Following careful clinical evaluation and confirmation of normal biochemical markers, the patient was diagnosed with aseptic loosening and underwent a planned revision total hip arthroplasty with a proximal femoral replacement (C).