Metallosis and Metal-induced synovitis following total knee arthroplasty: Review of Radiographic and CT Findings

Jason W. Romesburg, Paul L. Wasserman, Candace H. Schoppe

Research output: Contribution to journalArticle

35 Scopus citations


Metallosis and metal-induced synovitis are well-recognized complications of metal-backed polyethylene joint prostheses and have been frequently described in the orthopedic surgery literature; however, relatively fewer articles discussing the radiologic aspects of this complication have been published. To illustrate the importance of radiologic findings in the diagnosis and management of these patients, we present a case of metallosis and metal-induced synovitis complicating two revisions of a total knee arthroplasty, caused by polyethylene liner wear and dissociation of the polyethylene liner from the metal-backed patellar prosthesis. Specific attention is given to reviewing signs that aid in diagnosis, such as the "bubble sign," "cloud sign," and "metal-line signs".

Original languageEnglish (US)
Pages (from-to)7-17
Number of pages11
JournalJournal of Radiology Case Reports
Issue number9
StatePublished - Oct 8 2010



  • Bubble sign
  • Cloud sign
  • Metal-induced synovitis
  • Metal-line sign
  • Metallosis
  • Periprosthetic osteolysis
  • Polyethylene liner failure
  • Total knee arthroplasty complications

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this