Femur

Question 1

AP - Hip down femur positioning

Answer 1

Patient is supine on table
Affected leg is aligned straight along table
Rotate femur internally 10deg

Question 2

Evalution Critique for AP - hip down femur

Answer 2

Femoral neck clearly seen
> Greater trochanter seen in
profile- adequate internal
rotation
> Lesser trochanter visible

Question 3

centring for AP hip down femur

Answer 3

distal to lesser trochanter

Question 4

AP knee up femur positioning

Answer 4

Patient is supine on table
Affected leg is aligned straight along table
Rotate femur internally 10deg

Question 5

Evalution Critique for AP knee up femur

Answer 5

proximal tibia and fibula and
distal femur, including soft tissue
> Femorotibial joint space open
> Femoral and tibial condyles
should appear symmetrical
> Patella superimposed on midline of femur
> Medial half of fibula head
superimposed on tibia
> Density and contrast optimal to
visualize bone & soft tissue

Question 6

Lateral hip down femur positioning

Answer 6

From supine position, roll patient’s pelvis up 45 degrees onto affected
side- use sponge to support

Abduct femur so that it is flat on the table (femur is at a diagonal angle to
the table instead of aligned down table as in below image)

Question 7

Evalution Critique for lateral hip

Answer 7

Regional anatomy included
– entire hip and most of
femur, including soft tissue
> Hip joint demonstrated
> Density and contrast
optimal to visualise bone &
soft tissue up femur

Question 8

lateral knee up femur positioning

Answer 8

From lateral hip down position, continue to roll patient all the way onto affected side
as per lateral knee position

Unaffected leg can go in front/ behind depending on patient mobility- need to move
out of the way to ensure overlap with lateral hip down radiograph

Knee flexed approx. 30 degrees

Question 9

evaluation for lateral knee up femur

Answer 9

Femoral and tibial condyles
should appear superimposed
(not always possible due to
divergent beam and centring
mid shaft)

> Patella in profile
Fibular head only slightly
superimposed over tibia

Question 10

type of neck fractures on femur

Answer 10

Question 11

Paget’s disease

Answer 11

the body absorbs old bone
and forms abnormal new bone

Thickened cortex with coarsened trabeculae

Question 12

Exostosis

Answer 12

Overgrowth of bone and cartilage extending from the surface

Question 13

OSTEOMYELITIS:

Answer 13

Occludes blood vessels, leading to bone necrosis

central area of radiolucency with a surrounding thick rim of reactive bone sclerosis,