How serious is this patient’s post-replacement knee pain?

This 69-year-old presents with knee pain post knee replacement. There is bone loss. Is it aggressive or non-aggressive?

Bone window setting CT coronal reformat

Bone window setting CT sagittal reformat

Bone window setting sagittal CT reformat

No, this is not aggressive. Posterior zone of transition is too sharp and a little sclerotic (green arrows). There is osteolysis from metal prosthesis with dense material (orange arrow) in the suprapatellar pouch, e.g. particulate disease, metallosis and/or ALVAL aseptic lymphovascular associated lesion. MR often shows metallosis better than CT. For more knee case review, check out MRI Online.

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