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FINDINGS:Previous left hip joint metal on metal prosthesis (Birmingham). There is asymmetry of the femoral head component within the acetabulum consistent with component wear. Expansile lesion in the left superior pubic ramus measures around 3-4 cm. There are further well defined lytic lesions in the acetabulum and around the femoral stem. These are likely to be granulomas related to particle disease.
Note is made of undercoverage of the right femoral head with an upward sloping acetabulum indicating mild right acetabular dysplasia with secondary degenerative change.
At left hip revision surgery, there was metallosis in the soft tissues, synovitis and lytic granulomas in the pubic bone, ischium, femoral neck and acetabulum.
Fibrous capsule with attached adipose tissue and skeletal muscle. The fibrous tissue contains numerous pigmented macrophages. No acute inflammatory or neoplastic features are identified.