RT Book, Section
A1 Marchie, Anthony
A1 Freiberg, Andrew A.
A1 Kwon, Young-Min
A2 Imboden, John B.
A2 Hellmann, David B.
A2 Stone, John H.
SR Print(0)
ID 57271534
T1 Chapter 13. Approach to the Patient with a Painful Prosthetic Hip or Knee
T2 CURRENT Diagnosis & Treatment: Rheumatology, 3e
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-163805-0
LK accessmedicine.mhmedical.com/content.aspx?aid=57271534
RD 2024/04/18
AB A  thorough  clinical  history  and  a  detailed  physical  examination  are  essential  to  delineate  various  intrinsic  and  extrinsic  causes  of  pain  in  patients  with  hip  and  knee  total  joint  replacements.Radiographs  with  orthogonal  and  weight-bearing  views  should  be  ordered  to  assess  signs  of  implant-related  complications.Laboratory  investigations  should  include  both  erythrocyte  sedimentation  rate  (ESR)  and  C-reactive  protein  (CRP)  as  screening  serologic  markers  for  joint  infection.A  high  index  of  suspicion  for  infection  must  always  be  maintained,  especially  in  patients  with  comorbidities  such  as  diabetes,  inflammatory  arthritis,  and  compromised  immunity.Awareness  of  adverse  soft-tissue  reaction  to  metal  wear  debris  in  patients  with  painful  metal-on-metal  total  hip  replacements  is  important  in  light  of  its  increasing  use  in  young  and  active  patients.