Femur, Hip, Pelvis, WB Studies

Question 1

What method name will demonstrate the lateral hip joint while utilizing a horizontal CR?

Answer 1

Danelius- Miller

Question 2

What is the degree and direction that the leg should be turned for an AP pelvis and why should this be done?

Answer 2

15-20 degrees inverted (medially rotated) direction to pull the femoral necks parallel to the IR. This also pulls the greater trochanter in profile.

Question 3

List the proper SID used for the following exams.
Leg length study --1--
Upright pelvis --2--
AP proximal femur --3--
"Frog" lateral --4--

Answer 3

Leg length study- 8 feet/96 inches
Upright pelvis- 72 inches
AP proximal femur- 40 inches
“Frog” lateral- 40 inches

Question 4

What is the method name for a “frogleg” of the hip?

Answer 4

Modified Cleaves Method

Question 5

What device is used to even out the various densities that are present on a leg length study?

Answer 5

Compensating filter (thick part of filter; put towards he knee/ankle)

Question 6

For the lateral distal femur radiograph the knee should be flexed –1– degrees and the –2– will be somewhat superimposed (not completely due the divergence of the CR).

Answer 6

1. 45 degrees

2. femoral condyles

Question 7

For the AP hip radiograph where should the film be placed?

Answer 7

Top of film at ASIS

Question 8

For the x-table lateral hip position, the CR should be –1– to the femoral neck while the IR should be –2–.

Answer 8

1. perpendicular

2. parallel

Question 9

When performing the AP pelvis the CR should be directed to –1–.

Answer 9

2 inches below ASIS

Question 10

The portion of the pelvis that we sit on is called the –1–.

Answer 10

Ischial Tuberosity

Question 11

When the feet/ legs are –1– the lesser trochanters will be demonstrated or seen best.

Answer 11

Everted

Question 12

In order to adequately demonstrate the entire pelvis and upper 1/2 of the femurs in the weight bearing position the film is best placed –1–.

Answer 12

Lenghtwise

Question 13

The age of the pediatric hip study is –1–.

Answer 13

4 mths- 17 yrs old

Question 14

The age of the infant hip study is –1–.

Answer 14

1 day- 4 mths

Question 15

The “AP hip” projection/position/view is theoretically the same as the –1–.

Answer 15

AP proximal femur

Question 16

Explain how we would perform the bilateral Modified Cleaves Method for hips.

Answer 16

Flet? hips and knees so femurs are vertical. Abduct femurs and place soles of feet together. The degree varies between 25-45 degrees. Make sure you have equal abduction of both femurs and center 1 inch above pelvis symphysis. (Maybe?)

Question 17

Why would a frog leg be contraindicated for hip and/or femur studies?

Answer 17

If the patient has a suspected fracture, prosthetic device, or other pathologic disease.

Question 18

What are 2 important instructions to give your patient when performing an upright weight bearing pelvis study?

Answer 18

1. Remove shoes (may have a lift in shoes)

2. Stand with equal weight on both feet. (will throw measurements off)

Question 19

For bilateral “frog” or Modified Cleaves Method, the CR should be directed to –1–.

Answer 19

1 inch superior to the pubic symphysis

Question 20

For the unilateral “frog” or Modified Cleaves Method, the CR should be directed to the –1–.

Answer 20

femoral neck

Question 21

What anatomy must be included on the weight bearing leg length radiograph?

Answer 21

hip joint t ankle joint

Question 22

Any weight bearing study of the joints is used to demonstrate the possible presence of –1–.

Answer 22

joint space narrowing

Question 23

What specific “hip/pelvic” structure is used to measure leg length when shown in a weigh bearing position?

Answer 23

acetabulum

Question 24

What should be done to the unaffected leg when performing a lateral distal femur?

Answer 24

draped up over the affected leg

Question 25

What should be done to the unaffected leg when performing a lateral proximal femur?

Answer 25

It should be placed posteriorly

Question 26

List the structures with the fractional divisions and anatomic directions that make the acetabulum.

Answer 26

1. Ilium 2/5 superiorly
2. Ischium 2/5 posteriorly
3. Pubis 1/5 anteriorly

Question 27

List the 3 ways to localiz the hip joint.

Answer 27

1. Bisect “crease” of leg/hip
2. Go in 2 inches from greater trochanter
3. Locate ASIS and pubic symphysis, bisect this line and come down at a right angle 2 inches.

Question 28

What should be done with the unaffected leg when performing the cross table lateral (axiolateral projection) for hip?

Answer 28

Elevated to place the thigh in a vertical position (Danelius-Miller Method)

Question 29

From a technical standpoint, what are some ways to improve the image quality when performing the cross-table lateral hip?

Answer 29

1. Use a grid
2. Collimate
3. Compensating Filter
4. Part in center of IR

Question 30

The proper respiration for femur, hip, and pelvis should be –1–.

Answer 30

suspend respiration