Acute asymptomatic pulmonary thromboembolism detected using dynamic digital radiography following total hip arthroplasty: a case report.

BACKGROUND: Acute pulmonary thromboembolism is a serious complication of total hip arthroplasty that may be asymptomatic, underscoring the importance of early detection. Contrast-enhanced computed tomography is the standard diagnostic modality; however, its use is limited by its invasiveness, radiation exposure, contrast allergy, and renal dysfunction. Dynamic digital radiography is a novel, minimally invasive imaging technique that enables visualization of pulmonary perfusion without contrast agents.

CASE SUMMARY: We report a case of a 58-year-old woman who underwent primary total hip arthroplasty. Post-operatively, the patient remained asymptomatic. One week after total hip arthroplasty, follow-up dynamic digital radiography demonstrated newly developed pulmonary perfusion abnormalities, with marked signal reduction in the right middle and lower lung zones, and a mild reduction in the left upper lung zone. Subsequent contrast-enhanced computed tomography confirmed bilateral pulmonary thromboembolism corresponding to perfusion defects detected using dynamic digital radiography. Anticoagulant therapy completely resolved the thromboembolism.

DISCUSSION: This case highlights the potential utility of dynamic digital radiography for early detection of asymptomatic acute pulmonary thromboembolism following total hip arthroplasty.