67-year-old man who presented with proximal thigh pain 18 months after modular metallic hip arthroplasty placement performed at outside institution.
A–C, Axial (A), coronal (B), and sagittal (C) proton density–weighted fast spin-echo MR images show osteolysis in Gruen zone 8 (arrow, A), zone 7 (arrow, B), and zone 14 (arrow, C).
D and E, Corresponding anteroposterior (D) and frog lateral (E) radiographs of left hip show resorption around proximal femur in region of porous coat with radiolucency in Gruen zone 1 (arrow, D), zone 8 (white arrow, E), and zone 14 (black arrow, E). Tissue obtained at time of femoral component revision showed fibrinous exudate at bone-implant interface with intraoperative cultures negative for infection.