84-year-old female with left hip pain and history of cardiac catheter/left hip replacement. Evaluation of the surrounding soft tissues of the left and right hip is limited by metallic susceptibility artifact related to the patient's bilateral total hip arthroplasty devices.We see no abnormal signal within the bones of the left hip adjacent to the prosthesis. There is a small amount of fluid adjacent to the neck of the prosthesis, which we suspect is within normal limits. We see no large fluid collections about the hip. There is mild to moderate atrophy of the gluteal musculature on the left. We see no large hematoma. The large field-of-view images show a right total hip arthroplasty with associated metallic susceptibility artifact. There is a collection of fluid along the lateral aspect of the proximal portion of the right femoral stem within the soft tissues that measures approximately 6.5 cm in the craniocaudal dimension, 4.5 cm in the transverse dimension, and 1.5 cm and the medial to lateral dimension. This is nonspecific and may represent a chronic seroma, however, dedicated radiographs are recommended to exclude osteolysis of the greater trochanter, as the majority of the trochanter itself is not well visualized. The bone along the distal aspect of the femoral stem and acetabulum appears normal. There is severe fatty atrophy of the gluteus medius and minimus muscles. The gluteus minimus tendon appears to extend to a small fragment of the greater trochanter that is not clearly affixed to the remainder of the prosthesis or other remainder of the femur. There is mild fatty atrophy of the gluteus maximus. There is mild osteoarthritis of the pubic symphysis. Severe degenerative disc disease affects the level of L5/S1. Mild degenerative disc disease affects the levels of L3/L4 and L4/L5.
1. Left total hip arthroplasty without evidence of hardware complication. There is mild atrophy of the gluteal musculature on the left.2. Right total hip arthroplasty with a crescentic fluid collection along the lateral aspect of the proximal femur as well as severe fatty atrophy of the gluteus medius and minimus muscles as described above. Radiographs of the right hip are recommended to evaluate for osteolysis of the greater trochanter.3. Degenerative disc disease of the lower lumbar spine.