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Radiographic Procedures > Ch 8 - Hip & Pelvis > Flashcards

Ch 8 - Hip & Pelvis Flashcards

1
Q

What is the function of the pelvis?

A

Serves as a base for the trunk and a girdle for the attachment of the lower limbs

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2
Q

How many bones make up the pelvis?

A
  • 2 hip bones
  • Sacrum
  • Coccyx
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3
Q

How does the shape of a female pelvis compare to a male pelvis?

A

Female is wider and shallow while Male is narrow and deep

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4
Q

How does the bony structure of a female pelvis compare to a male pelvis?

A

Female is light and Male is heavy

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5
Q

How does the inlet of a female pelvis compare to a male pelvis?

A

Female is oval shaped and Male is round

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6
Q

How does the outlet of a female pelvis compare to a male pelvis?

A

Female is wide (obtuse angle) and Male is narrow (acute angle)

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7
Q

How many portions is the pelvis divided into?

A

2 portions from the upper anterior margin of the sacrum to the upper margin of the pubic symphysis

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8
Q

What are the two portions of the pelvis called?

A

False/greater pelvis and True/lesser pelvis

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9
Q

What portion of the pelvis is the false pelvis?

A

Region above the brim

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10
Q

What portion of the pelvis is the true pelvis?

A

Region below the brim

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11
Q

What does the Hip bone consist of?

A

3 bones called the ilium, ischium and pubis

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12
Q

Where do the 3 bones of the hip join?

A

At the acetabulum

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13
Q

What is the acetabulum

A

Cup shaped socked that receives the head of the femur

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14
Q

What are the distinct areas of the hip?

A

Iliopubic column and the ilioischial column

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15
Q

What are the two columns of the hip used to identify?

A

Fractures around the acetabulum

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16
Q

What does the ilium consist of?

A

A Body and a broad curved portion on the superior surfaced called the ala

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17
Q

What part of the acetabulum does the ilium make up?

A

Two-fifths of the acetabulum

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18
Q

How many borders does the Ala have?

A

3 borders: anterior, posterior and superior

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19
Q

What prominent projections are formed by the anterior and posterior borders of the Ala?

A
  • ASIS (anterior superior iliac spine)
  • anterior inferior iliac spine
  • Posterior superior iliac spine
  • Posterior inferior iliac spine
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20
Q

Why is the ASIS important in radiology?

A

It’s a significant body landmark for palpating

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21
Q

What is the iliac crest?

A

The superior margin extending from the ASIS to the posterior iliac spine (top curve of the hip)

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22
Q

What does the pubis consist of?

A

A body, superior ramus and inferior ramus

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23
Q

What part of the acetabulum does the pubis make up?

A

One-fifth of the acetabulum

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24
Q

What does the ischium consist of?

A

Consist of a body and the ischium ramus

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25
What part of the acetabulum does the ischium make up?
Two-fifths of the acetabulum
26
Where does the ischium project?
Posteriorly and inferiority from the acetabulum to form the ischium tuberosity
27
When the body is seated where is the weight resting on in the hip?
On the ischial tuberosities
28
What are the articulations of the hip joint?
Articulation between the acetabulum and the head of the femur
29
What type of joint is the hip joint?
Synovial ball and socket that permits free movement in all directions
30
What is the pubic symphysis?
Articulation between the pubis of the hip bones and the exterior midline of the body
31
What type of joint is the pubic symphysis?
Cartilaginous symphysis joint
32
What is the sacroiliac?
Articulation between the left and right ilia with the sacrum posteriorly
33
What is the angle of the SI joint in relation to the MSP?
15-20 degrees
34
What type of joint is the SI joint?
Synovial gliding joint, allowing the bones of the joint to interlock to limit movement
35
What is the highest point on the hips?
Iliac crests
36
How can the pubic symphysis be localized without palpating?
By locating the greater trochanter which lies in the same plane
37
How can the greater trochanter be palpated?
Can be found immediately below the depression in the soft tissue of the lateral surface of the hip
38
What bones are at the same level of the greater trochanter?
Midpoint of the hip, coccyx and pubic symphysis
39
How can the femoral neck be identified?
By drawing an imaginary line between the ASIS and pubic symphysis and moving 2.5 inches down from the midpoint between the two
40
What is the position of the part for AP Pelvis?
- MSP centered to the midline of the grid - Feet and lower limbs medially rotated 15-20 degrees - ASIS equal distance from the tabletop
41
Where is the central ray directed for AP Pelvis?
Perpendicular to the IR and midway between the level of the ASIS and pubic symphysis
42
What structures are demonstrated in AP Pelvis?
An AP projection of the pelvis, and head, neck, trochanters and proximal one-third of the femoral shaft
43
What are the evaluation criteria for AP pelvis?
- Entire pelvis and proximal femora - Both ilia and greater trochanters equidistant from the edge of the radiograph - lower vertebral column centered to the midline of the radiograph - No rotation of the pelvis - Proper rotation of the femora
44
How is no rotation demonstrated in AP Pelvis?
- Symmetrical ilia - Symmetrical obturator foramen - Ischial spines equally seen - Sacrum and coccyx aligned with the pubic symphysis
45
How is proper rotation of the femora demonstrated in an AP Pelvis?
- Femoral necks in the full extent without superimposition - greater trochanter in profile - Lesser trochanter not visible
46
What is the purpose of the AP Oblique - Bilateral and Unilateral Frog Leg Projection?
To see an oblique view of the femoral necks
47
How is the part positioned for AP Oblique Hip - Bilateral “Frog Leg”?
- MSP centered to the midline of the grid - Patient’s arms rested on upper chest - Pelvis adjusted so its not rotated - Hips and knees flexed and drawn up as much as possible - Femora abducted 40-45 degrees with feet turned inwards and soles against each other - feet centered to the midline of the grid - IR centered 1 inch superior to the pubic symphysis
48
Where is the central ray directed for an AP Oblique Hip - Bilateral Frog Leg?
Perpendicular and 3 inches below the level of the ASIS or 1 inch above the pubic symphysis
49
What are the structures demonstrated in an AP Oblique Hip - Bilateral Frog Leg?
AP oblique projection of the femoral heads, necks and trochanteric areas on one radiograph for comparison
50
What is the evaluation criteria for AP Oblique Hip - Bilateral Frog Leg?
- No rotation of the pelvis - pelvis girdle centered - Acetabulum, Femoral head and Femoral necks visualized - Lesser trochanter equal in side on the medial side of femur - greater trochanter superimposed over the Femoral neck
51
What is the part position for the Unilateral Frog Leg Projection?
- Adjust the patient so that the pelvis is not rotated - Adjust the body to center the ASIS of the affected side to the midline of the grid - Have the patient flex the hip and knee of the affected side and draw foot up to the opposite knee as much as possible - Have the patient brace the sole of their foot against the opposite knee and abduct the thigh laterally 45 degrees to the tabletop
52
Where is the central ray positioned for the Unilateral Frog Leg Projection?
Perpendicular and centered to the femoral neck
53
What is the evaluation criteria for the Unilateral Frog Leg Projection?
- Entire Femoral head, neck, and trochanters centered to IR - Femoral head and neck in profile
54
How is the part positioned for AP Hip?
- Patient supine on table with ASIS equidistant from the tabletop - Arms placed in a comfortable position - Feet and lower legs medially rotated 15-20 degrees and 8-10 inches apart
55
Where is the central ray directed for AP Hip?
Perpendicular to the mid-femoral neck of the affected hip
56
What structures are demonstrated in the AP Hip?
Head, neck and trochanters and proximal 1/3 of the body of the femur
57
What is the evaluation criteria for AP Hip?
- Regions of the ilium and pubic bones adjoining the pubic symphysis - Hip joint - proximal 1/3 of the femur - Femoral head seen through the acetabulum - Entire long axis of the femoral neck not foreshortened - Proper rotation of the femora
58
How is proper rotation of the femora demonstrated in AP Hip?
- greater trochanter in profile - Lesser trochanter not visible
59
What is the part position for the Axiolateral Hip - Inferosuperior (DANELIUS-MILLER METHOD)
- Patient in the supine position with knee and hip of the unaffected side flexed and elevated to a vertical position - Unaffected leg rested upon suitable support - Pelvis adjusted so its not rotated - Medially rotate the foot and lower leg of the affected side 15-20 degrees
60
What is the position of the IR for the Axiolateral Hip - Inferosuperior (DANELIUS-MILLER METHOD)
IR placed in the vertical position with its upper border in the soft tissue crease of the iliac crest and angled away from the body until its parallel to the femoral neck
61
What is central ray positioned for the Axiolateral Hip - Inferosuperior (DANELIUS-MILLER METHOD)
Horizontal and perpendicular to the mid-femoral neck and IR (Enters groin area at a midway point between the anterior and posterior surfaces of the upper thigh)
62
What are the structures demonstrated in the the Axiolateral Hip - Inferosuperior (DANELIUS-MILLER METHOD)
Acetabulum, head, neck and trochanters of the femur
63
What is the evaluation criteria of the Axiolateral Hip - Inferosuperior (DANELIUS-MILLER METHOD)
- hip joint within the Acetabulum - Femoral neck without overlap from the greater trochanter - Small amount of the Lesser trochanter on the anterior and Posterior surfaces of the proximal femur - Ischial tuberosity below the Femoral head and neck
64
When should the Modified Axiolateral Hip (Clements-Nakayama Method) be used?
When the patient has bilateral hip fractures, bilateral hip arthroplasty (plastic surgery of the hip joints), or limitation of movement of the unaffected leg and the Danelius-Miller method cannot be used.
65
What is the part position for the Modified Axiolateral Hip (Clements-Nakayama Method)
- Patient supine on the table with the affected side near the edge of the table - Leg and foot of the affected side in the neutral position - IR positioned standing in the table Bucky crosswise and adjusted to the axis of femoral neck and tilted back 15 degrees
66
Where is the central ray positioned for the modified Axiolateral hip (Clements-Nakayama Method)
Directed 15 degrees posteriorly and aligned perpendicular to the femoral neck and the grid IR
67
What are the structures demonstrated in the Modified Axiolateral Hip (Clements-Nakayama Method)?
The acetabulum and proximal femur- including the head, neck and trochanters in lateral profile
68
What is the evaluation criteria for Modified Axiolateral Hip (Clements - Nakayama Method)?
- hip joint within the Acetabulum - Femoral head, neck and trochanters - orthopedic appliances in their entirety
69
What is the patient position for the PA Axial Oblique Projection- Acetabulum (Teufel Method) - RAO/LAO
Patient in the prone position with the hip centered to the midline of the grid and unaffected side raised to a 35-40 degree angle with the table
70
How is the central ray position for the PA Axial Oblique Projection- Acetabulum (Teufel Method) - RAO/LAO
Angled 12 degrees cephalic and entering the body 1” superior to the downside of the greater trochanter (or at the level of the coccyx and 2 inches lateral to the MSP towards the side being examined)
71
What are the structures demonstrated in the PA Axial Oblique Projection- Acetabulum (Teufel Method) - RAO/LAO
Fovea cavities and the superoposterior wall of the acetabulum
72
What is the evaluation criteria of the PA Axial Oblique Projection- Acetabulum (Teufel Method) - RAO/LAO
- hip joint and Acetabulum near the center of the radiograph - Femoral head in profile to show the concave area of the fovea capitis - Superoposterior wall of the Acetabulum
73
What is the AP Oblique Judet method exam used for?
To diagnose fractures of the acetabulum and to demonstrate the ilioischial and iliopubic columns of the affected side
74
Why is the AP Oblique - Judet projection - RPO External Oblique position used ?
Used for patients with a suspected fracture of the ilioischial column and anterior rim of the acetabulum
75
How is the patient positioned for the AP Oblique - Judet projection - RPO External Oblique
Patient placed in the supine position with the right hip (affected side down) centered to the midline of the grid and the left hip (unaffected side) raised to a 45 degree angle with the table
76
Why is the AP Oblique - Judet projection - LPO Internal Oblique position used ?
Used for patients with a suspected fracture of the iliopubic column and the posterior rim of the acetabulum
77
How is the patient positioned for the AP Oblique - Judet projection - LPO Internal Oblique
Patient placed in the supine position with the left hip (unaffected side) centered to the midline of the grid and the right hip (affected side up) raised to a 45 degree angle with the table
78
Where is the central ray positioned for the AP Oblique - Judet projection RPO/LPO position?
Perpendicular to the IR entering 2 inches inferior to the ASIS of the affected side
79
Where are the structures demonstrated in the the AP Oblique - Judet projection RPO/LPO position?
Acetabular rim
80
Where is the evaluation criteria for the AP Oblique - Judet projection - RPO position?
- Acetabulum in the center of the radiograph - Ilioischial column and the anterior rim of the Acetabulum on the external oblique
81
Where is the evaluation criteria for the AP Oblique - Judet projection - LPO position?
- Acetabulum in the center of the radiograph - Iliopubic column and Posterior rim of the affected Acetabulum on internal oblique
82
How is the part positioned for the AP Axial “Outlet” Projection (Taylor Method)?
- MSP centered to the midline of the grid and pelvis adjusted so its not rotated - knees flexed slightly
83
Where is the central ray projected for Men in the AP Axial “Outlet” Projection (Taylor Method)?
Men: 35 degrees cephalic and centered to the midline and a point 1-2 inches distal to the pubic symphysis
84
Where is the central ray projected for Women in the AP Axial “Outlet” Projection (Taylor Method)?
Women: 30-45 degrees cephalic and enters the midline at a point 1-2 inches distal to the pubic symph
85
What are the structures demonstrated in the AP Axial “Outlet” Projection (Taylor Method)?
Superior and inferior rami without foreshortening
86
What are the evaluation criteria for the AP Axial “Outlet” Projection (Taylor Method)?
- Elongated and magnified pubic and Ischial bones - No rotation of the pelvis - pubic and Ischial bones centered to collimation field
87
How is the part positioned for the AP Axial “Inlet” Projection (Superoinferior Axial)?
- MSP centered to the midline of the grid and pelvis adjusted so its not rotated - knee flexed slightly
88
Where is the central ray projected in the AP Axial “Inlet” Projection - Superoinferior Axial?
Angled 40 degrees caudal and entering the midline at the level of the ASIS
89
What are the structures demonstrated in the AP Axial “Inlet” Projection - Superoinferior Axial?
An axial projection of the inlet (pelvic ring) in its entirety
90
What are the evaluation criteria of the AP Axial “Inlet” Projection - Superoinferior Axial?
- Ischial spines demonstrated equally - pelvis inlet centered - lateral collimation evident
91
What are the two AP Projections of the pelvis recommended when there is a congenital dislocation of the hip?
- Projection 1 is when the CR is perpendicular to the pubic symph to detect any lateral or superior displacement of the femoral head. - Projection 2 is when the CR directed to the pubic symphysis at a cephalic angulation of 45 degrees
92
What does the 45 degree cephalic angle of projection 2 demonstrate in the AP projection of the pelvis when dislocation is suspected?
Shows the exact type of dislocation - Shadow of the femoral head above that of the acetabulum shows and anteriorly dislocation and the shadow of femoral head below that of the acetabulum shows a posteriorly dislocation.
93
What examination is contraindicated for a patient suspected to have a fracture or other pathologic disease?
Bi-lateral and uni-lateral Frog's

Radiographic Procedures (7 decks)

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