What is the most likely diagnosis?

• 63 year-old with hip replacement 4 years earlier

Frontal and Lateral Hip Radiographs

1. Osteosarcoma
2. Mechanical loosening
3. Eosinophilic granuloma
4. Particle disease
5. Paget Disease

Additional Image - Frontal hip radiograph 2 years later

 

 

Additional Images

 

Frontal hip radiograph 2 years later

Answer:

.

4. Particle Disease

.

.

More (Click Discussion Tab)

Particle Disease

General Considerations

• Occurs from inflammation and osteolysis secondary to the shedding of portions of a prosthesis, more often the polyethylene and/or methylmethacrylate cement in submicron size
• The granulomatous response elicited manifests as osteolysis
• Typically occurs 1-5 years after surgery, now most often in cementless prostheses
• The head may be made out of a cobalt-chromium alloy with a polyethylene cup
• Particles may migrate along the entire course of the prosthesis

 

MORE...