Radiograph of the pelvis in a adult patient. Bilateral hip prosthesis demonstrated. Satisfactory position of the left prosthesis. Right hip prosthesis appears to be dislocated. There is evidence of a localised fracture with adjacent permeative change involving the acetabulum. Appearance on imaging is suggestive of a pathological fracture. This could represent a primary localised neoplasm such as a plasmacytoma or metastases. I would urgently conveyed the findings to the referring physician and suggest the patient mobilise with a chair. I would also suggest an urgent MRI scan of the pelvis as well as a staging CT examination and urgent orthopaedic referral.