Hidden dangers: the radiologist's role in diagnosing arterial injuries after orthopaedic surgery of the lower limb.

Orthopedic surgery is the most common intervention performed on the lower limb. Although rare (0.005-0.5%), the incidence of iatrogenic arterial injuries is increasing due to the rising use of prosthetic implants and broader surgical indications in aging populations. Imaging findings are diverse and include hemorrhage, pseudoaneurysm, hemarthrosis, endomedullary bleeding, retraction-induced microvascular injury, stenosis, and occlusion. However, evaluation is often complicated by artifacts from metallic hardware. This pictorial review illustrates the radiological spectrum of these injuries, offers practical tips to optimize imaging quality, and proposes a structured algorithm to guide timely and effective diagnosis and management.