HSS - What's the Diagnosis - Case 88

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What’s the Diagnosis – Case 88

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What’s the Diagnosis – Case 88

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What’s the Diagnosis – Case 88

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What’s the Diagnosis – Case 88

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What’s the Diagnosis – Case 88

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What’s the Diagnosis – Case 88

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What’s the Diagnosis – Case 88

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What’s the Diagnosis – Case 88

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What’s the Diagnosis – Case 88

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What’s the Diagnosis – Case 88

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What’s the Diagnosis – Case 88

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Findings The postoperative radiograph is normal and the MRI is obtained the next day. On the proton density images which are optimized in the setting of a joint replacement, no findings are definitive. But on the MAVRIC sequence further developed to reduce artifact from metal when MRI’s are obtained, there is a layer of high signal/fluid interposed between the low signal polyethylene and low signal tibial component.

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What’s the Diagnosis – Case 88

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Diagnosis: Polyethylene Separation In the setting of a total knee arthroplasty or a unicompartmental arthroplasty, the polyethylene component is engaged with the tibial component be it in a mobile bearing or fixed bearing construct. There are multiple types of knee prosthesis and at times there can be confusion about an unseating or separation of the polyethylene if a minimal amount of high signal is seen interposed between the low signal polyethlene and the low signal tibial tray. However, a band of high signal fluid should never exist between the two low signal components and indicates a failure of engagement of the polyethylene component or separation of the polyethylene from the tibial tray.

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