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A retrospective study was performed to determine the accuracy of 99mTc-methylene diphosphonate bone imaging in the evaluation of total hip arthrosplasty for lossening and/or infection. Using focally increased activity at the tip of the femoral component or in the region of the acetabular component as a criterion, the examination was 77% specific and 100% sensitive for loosening and/or infection. A possible explanation for the increased uptake at the tip of the femoral component and the role of this examination in the management of a painful total hip prosthesis are discussed.
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