Imaging evaluation of the painful total joint arthroplasty has, in the past, been limited to conventional radiographs, arthrography, and nuclear scintigraphy. All three modalities provide some clinical information regarding the status of the prosthesis, adjacent bone, and surrounding soft tissues but are hampered by poor specificity, particularly nuclear scintigraphy. Magnetic resonance imaging, using optimized pulse sequences to reduce the susceptibility artifact generated by the arthroplasty, can provide clinically relevant information regarding the prosthesis as well as the surrounding bone, soft tissues, and neurovascular structures.