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MRI of Failed Total Hip Replacement Caused by Abductor Muscle Avulsion

Akram Twair1, Martin Ryan, Martin O'Connell, Tom Powell, John O'Byrne and Stephen Eustace

1 All authors: Department of Radiology, Master Misericordiae and Cappagh National Orthopedic Hospital, Finglas, Dublin 11, Ireland.



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  		Fig. 1A. —76-year-old woman with clinical abductor failure. Anteroposterior radiograph of pelvis shows left total hip replacement in situ without evidence of loosening or infection.

 


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  		Fig. 1B. —76-year-old woman with clinical abductor failure. Coronal turbo spin-echo T1-weighted image (TR/TEeff, 550/12; echo-train length, 4) shows metal artifact (straight arrow) at site of hip prosthesis. Note avulsion, retraction, and atrophy of left glutei with interposed hypointense fluid (curved arrow).

 


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  		Fig. 1C. —76-year-old woman with clinical abductor failure. Coronal turbo STIR image (2,500/40; echo-train length, 24) shows hyperintense fluid (arrow) at site of retraction, confirming abductor avulsion.

 


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  		Fig. 2A. —53-year-old woman after bilateral anterolateral approach total hip replacements. Anteroposterior radiograph of pelvis shows bilateral total hip replacements in situ without evidence of loosening or infection.

 


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  		Fig. 2B. —53-year-old woman after bilateral anterolateral approach total hip replacements. Coronal turbo spin-echo T1-weighted image (TR/TEeff, 550/12; echo-train length, 4) shows bilateral metal artifact at site of prostheses with intact abductors on right (straight arrow) and avulsed, retracted abductors on left (curved arrow).

 


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  		Fig. 2C. —53-year-old woman after bilateral anterolateral approach total hip replacements. Coronal turbo STIR image (2,500/40; echo-train length, 6) shows healthy abductors on right, with fluid over left greater trochanter at site of abductor avulsion (arrow).

 

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