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Identification and diagnosis of periprosthetic joint infection (PJI) are challenging, requiring a multi-disciplinary approach involving clinical evaluation, laboratory tests, and imaging studies. MRI is advantageous to alternative imaging techniques due to superior soft tissue contrast and absence of ionizing radiation. However, the presence of metallic implants can cause signal loss and artifacts. Metal artifact suppression (MARS) MRI techniques have been developed that mitigate metal artifacts and improve periprosthetic soft tissue visualization. This paper provides a review of the various MARS MRI techniques, their clinical applicability and accuracy in PJI diagnosis and evaluation, and current challenges and future perspectives. [ABSTRACT FROM AUTHOR]

Although not as common as hip or knee arthroplasty, shoulder arthroplasty is becoming a more common procedure. Reverse total shoulder arthroplasty (RTSA) is known to be an effective surgical procedure for massive irreparable rotator cuff tears, comminuted proximal humerus fractures, and revision shoulder arthroplasty. The utilization of RTSA has been increasing, and although complications following reverse arthroplasty have been reported, there are few reports in the literature that focus on the imaging features of RTSA. Herein, we demonstrate the biomechanics of RTSA, prosthesis components, indications, and imaging features of the normal postoperative appearance and various complications after RTSA. Familiarization with the normal and abnormal imaging appearances after RTSA can be helpful for appropriate management of patients. [ABSTRACT FROM AUTHOR]

The hallux sesamoids are vulnerable to significant injury and weight-bearing stress in both the athlete and the nonathlete. Unfortunately, they are often dismissed as inconsequential accessory bones. The historical significance, embryology, anatomy, and physiology of the sesamoids and the salient features of both traumatic and nontraumatic pathologic conditions affecting these structures are presented. Because the sesamoids can be responsible for prolonged disabling foot pain and discomfort, it is important for both clinician and radiologist to pay attention to these bones and recognize the early signs of abnormality. [ABSTRACT FROM AUTHOR]

We undertook a retrospective review of 78 percutaneous hip aspirations performed as a prerequisite to prosthetic revision or replacement. Although the majority of the patients were already scheduled for revision or replacement, many aspirations were requested as part of the "routine" algorithm in the evaluation of a painful hip. Cultures from the aspirated fluid were compared with those obtained intraoperatively (where possible) and to the clinical suspicion of infection. Many of the selected patients had clinical and/or radiographic indications of pain. Our results yielded no evidence of infection (0%) when there was no clinical suspicion of infection (60 patients). Clinical suspicion for infection was high in 7 patients; aspirates demonstrated infection in 5 of them. One aspiration was false negative for infection, but subsequent intraoperative cultures were positive. When the clinical suspicion was intermediate or equivocal (11 patients), results were negative in 9 and positive in 2, both at aspiration and intraoperatively. We contend that routine percutaneous hip aspirations do not need to be performed when a prosthetic revision or replacement is contemplated if the clinical suspicion for infection is low. Hip aspiration and arthrography should not be eliminated, however, when the clinical suspicion is equivocal or high or when there is no apparent cause for a painful prosthesis. [ABSTRACT FROM AUTHOR]