Please help

Dear OCAD colleagues

I encountered this MRI today. This is a 67 year old lady with known left knee replacement and revision in April 23. She started to have intense, medial knee pain on weight-bearing, biting; pinching type. I see the signal abnormality, at the medial tibial Metastasis away from the prosthesis. It is strange and the cortex is intact as you can see on the radiograph. Can the particle disease happen away from the prosthesis and not at all involve the prosthesis? What is the differential consideration?

Thank you in advance for your help.