Systemic Complications and Radiographic Findings of Opioid Use and Misuse: An Overview for Orthopedic Surgeons

  • Harry G. GreditzerIV
  • Dustin H. Massel
  • Carlos M. Barrera
  • Nisreen S. Ezuddin
  • Christopher P. Emerson
  • Jean Jose


Amid growing concern about the misuse of prescribed opioids, the rising rates of opioid use disorder, and the use of illicit opioids, clinicians in ambulatory, inpatient, and operative environments are encountering opioid-related complications in their patients. These complications can affect multiple organ systems including cardiovascular, pulmonary, gastrointestinal, and neurologic and are related to excess opioid levels in the body or contamination from non-sterile injection. It is important for the orthopedic surgeon to have a general understanding of the pathologies associated with opioid use disorder and their appearance on diagnostic imaging. This article reviews image findings of several complications, organized in a systems-based approach, for the orthopedic surgeon.


opioids diagnostic imaging complications of opioid use infective endocarditis arterial/mycotic pseudoaneurysm noncardiogenic pulmonary edema 


Compliance with Ethical Standards

Conflict of Interest

Harry G. Greditzer IV, MD, Dustin H. Massel, MD, Carlos M. Barrera, BS, Nisreen Ezuddin, BS, Christopher P. Emerson, MS, and Jean Jose, DO, MS, declare that they have no conflict of interest.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2013.

Informed Consent

Informed consent was waived from all patients for being included in this review.

Required Author Forms

Disclosure forms provided by the authors are available with the online version of this article.

Supplementary material

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Copyright information

© Hospital for Special Surgery 2018

Authors and Affiliations

  1. 1.Department of RadiologyHospital for Special SurgeryNew YorkUSA
  2. 2.UHealth Sports Medicine InstituteUniversity of Miami Miller School of MedicineMiamiUSA
  3. 3.Department of RadiologyJackson Memorial HospitalMiamiUSA

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