The use of ultrasound in the diagnosis of adverse reaction to metallic debris following metal on metal hip replacement

Background and purpose: The role of imaging in the diagnosis of adverse reaction to metallic debris (ARMD) with metal on metal (MoM) hip replacements is still unclear. A comparative study was undertaken to evaluate the efficacy of ultrasound in diagnosis of ARMD. Patients and methods: The study group included 35 patients with a clinical and histological diagnosis of ARMD. The control group included 16 asymptomatic patients of MoM hip replacements with low blood metal ions levels. Various sonographic features around hip in patients diagnosed with ARMD were recorded. Results and Interpretation: Fluid collection around iliopsoas and gluteal tendons following a MoM hip replacement is highly suggestive of ARMD and should not be thought of as an uncomplicated tendonitis. This study shows ultrasound as a reliable investigation in the diagnosis of ARMD following MoM hip replacements.