Previous reports have stressed the value of hip arthrography primarily in determining the presence of loosening of the total hip prosthesis. Although loosening is a common complication and frequently associated with infection, other complications producing a painful hip prosthesis exist and are demonstrable by arthrography. Since the etiologies of these are as diversely different as the treatment, the hip arthrogram is advocated as an integral part of the diagnostic approach to the patient with a painful hip prosthesis in order to assess the specific complication and determine the therapeutic approach.