Hip Arthroplasty: Periprosthetic Fractures

Periprosthetic fracture is any fracture occurring in the vicinity of an orthopedic implant. Radiographs are the first-line radiological investigation for the detection of periprosthetic fractures. Three-phase bone scan shows increased uptake in all three phases at the site of the fracture, which could be confused with septic loosening as the pain generator. SPECT/CT improves precise tracer uptake localization and helps identify periprosthetic fractures. Bone SPECT/CT may also be indicated in the follow-up of periprosthetic fractures to evaluate healing, delayed union, and nonunion. This chapter discusses the role of bone SPECT/CT in identifying periprosthetic fractures of the hip, illustrated with case material.