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

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.

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.

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