The Journal of Bone and Joint Surgery, Vol 73, Issue 7 1002-1007, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
Radiographic detection of metal-induced synovitis as a complication of arthroplasty of the knee
BN Weissman, RD Scott, GW Brick and JM Corson
Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts 02115.
Radiographs of eighteen patients who had had a diagnosis of metal-induced
synovitis subsequent to a knee-replacement arthroplasty were
retrospectively reviewed. The presence of a dense line outlining a portion
of the capsule or articular surface of the knee joint (the so-called
metal-line sign) was noted in association with wear in eleven patients. In
the nine patients who had a positive sign and also had specimens available
for histological examination, there was dense deposition of metal
particles, whereas in the six patients who did not have a metal-line sign
and had specimens available for histological examination, five had only a
slight amount of metal in the synovial tissue and one, a moderate amount.
The presence of the metal-line sign was associated with metal-induced
synovitis in eleven of the eighteen patients. The sign should be useful in
helping to make this diagnosis preoperatively in many patients.
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