E1647. Orthopedic Hardware Complications: More Than Just a Screw Loose
  1. Scott Myers; David Grant Medical Center
  2. Tae Ro; David Grant Medical Center
  3. Lance Edmonds; David Grant Medical Center
Post-surgical orthopedic imaging may be a significant source of anxiety or, at the opposite spectrum, a neglected topic for many radiologists. A significant portion of the radiologist workload includes orthopedic exams and are often evaluated on a daily basis. Building a foundational knowledge of orthopedic hardware and associated complications is critical for the accurate diagnosis and management of these patients.

Educational Goals / Teaching Points
In this educational exhibit, we will discuss some of the most commonly used orthopedic tools and the main complications that may arise. We will provide a case-based review of the common and uncommon complications that can be seen in post-surgical patients and highlight the main teaching points with each topic. Several of the complications that will be discussed include non-union, graft failure, particle disease, infection, loosening, hardware and peri-hardware fractures.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Often times, orthopedic hardware issues are conspicuous and easy to identify due to the size and contrast metallic hardware provides. However, there are many instances where it may be more subtle and tricky if one is unaware of the different complications that may manifest in post-surgical patients. A complete understanding can be strengthened with a knowledge of the different types of orthopedic devices. These surgical devices can range from small wires, screws, and rods to large intramedullary nails, external fixation devices, and joint prostheses. Knowing the specific trademark names for each device would be of poor clinical value but understanding the function can be useful in determining the type of complication and ultimately improve the final image interpretation.

The complications related to orthopedic hardware can be challenging to identify, but building a more comprehensive understanding of the various devices and their associated failures can improve the quality and accuracy of radiology reporting. It is our goal to provide an educational resource to introduce some of the more esoteric details of orthopedic hardware complications and, as a result, improve patient care.