Presentation
Known right hip arthroplasty. Recent fall and ongoing pain and limitation of motion.
Patient Data
Total, right hip, non-cemented arthroplasty with proximal femoral shaft cerclage wiring. Minimal eccentricity of the metallic femoral head in the acetabular cup on the supine pelvic and anteroposterior series. The oblique view confirms a posterosuperior femoral head dislocation as clinically suspected. The prosthesis and proximal femoral shaft are otherwise intact. Background likely osteoporosis,lumbar-sacral degenerative change, bilateral SI and left hip joint osteoarthritis.
Case Discussion
This is a companion case to rID 152401.
This patient has an unusual history of having two arthroplasty dislocations, initially the right shoulder and subsequently the right hip, 5 years apart. There is a background colon carcinoma, however, no obvious bony metastases are noted in the above views and the patient remains in remission.
The case demonstrates the need for multiple or tangential views to fully exclude joint and prosthetic dislocations or subluxations. The supine right hip series is misleading if the oblique or lateral view (shoot through) is not done.
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