NucMed Boards Prep
IMAGE INTERPRETATION · BONE IMAGING

Periprosthetic Uptake After Hip Replacement

Tc-99m MDP bone scan — hip region with prosthesis
Tc-99m MDP bone scan — hip region with prosthesis

CC BY 3.0 · Jarraya et al. / Wikimedia Commons · source file

Question

A bone scan performed 1 year after total hip replacement shows mildly increased uptake around the acetabular component and femoral stem tip. At what time AFTER hip replacement does normal post-operative bone remodeling uptake typically return to baseline on bone scan?

  1. A6–12 months for the acetabulum and prosthetic tip — uptake beyond this suggests loosening or infection
  2. B1 week post-operatively
  3. CUptake never resolves and is always present around prostheses
  4. D24–48 hours
Show the answer and explanation

A. 6–12 months for the acetabulum and prosthetic tip — uptake beyond this suggests loosening or infection

After total hip replacement (THR), normal post-operative bone remodeling causes increased uptake around the prosthesis for up to 6–12 months (sometimes 12–24 months for cemented prostheses). Uptake that PERSISTS beyond this expected time frame — particularly at the acetabulum, calcar, or femoral stem tip — raises concern for aseptic loosening, infection (periprosthetic joint infection), or stress fracture. Three-phase bone scan combined with labeled white blood cell (WBC) scan or In-111 WBC scan helps distinguish aseptic loosening from infection.

More bone imaging images

Whole-body bone scan — delayed phase imagesBone Scan Timing: When to Acquire Delayed Images Whole-body Tc-99m MDP bone scan, anterior and posterior projectionsNormal Whole-Body Bone Scan (Tc-99m MDP) Whole-body bone scintigraphy (Tc-99m)Diffuse Skeletal Metastases on Bone Scan Tc-99m MDP bone scan, focal uptake in the hip regionFemoral Neck Stress Fracture on Bone Scan Tc-99m MDP bone scan showing focal uptake at the femoral neckFemoral Neck Insufficiency Fracture on Bone Scan Three-phase bone scan: flow, blood pool, and delayed images of the lower extremityOsteomyelitis on Three-Phase Bone Scan
← Tc-99m Physical Half-LifeBone Scan Timing: When to Acquire Delayed Images →

All 130 nuclear medicine images by category →

Practise image interpretation in the app

All 130 images as an interactive quiz, alongside 500 NMTCB and ARRT(N) questions with worked explanations, case studies and timed mock exams. 25 questions are free, no card and no account.

Start free — no card

Download on the App StoreGet it on Google Play