Hip

Question 1

What is the most appropriate radiological modality after plain film for the hip?

Answer 1

US

Question 2

Is radiological modality indicated for pt. with suspected AVN of the hip:

Answer 2

plain film

Question 3

What is the pt. position for AP pelvis radiograph?

Answer 3

supine

Question 4

Male vs. female pelvis differences?

Answer 4

Male: circle, angle < 90
Female: oval, angle > 90

Question 5

What is a “teardrop”?

Answer 5

summation of shadows of medial acetabular wall

Question 6

What lines demarcate the anterior and posterior columns of the acetabulum?

Answer 6

iliopubic and ilioischial lines

Question 7

What position does pt. assume for lateral view of the hip ?

Answer 7

“foreleg view”

supine with leg flexed and abducted

Question 8

Indication for hip CT?

Answer 8

Severe trauma
Fracture alignment
Fractures of the sacrum and acetabulum
Measure bony alignment 
Any condition that MRI is contraindicated (remember ultrasound imaging too)

Intra-articular contrast can added

Question 9

Indications for hip MRI?

Answer 9

Osteonecrosis of the femoral head
Marrow abnormalities (transient osteoporosis)
Occult fractures/stress fractures
Adult sequela of childhood disorders
FAI
Labral tears
Musculotendinous disorders
Athletic pubalgia
Sacral plexus disorders

Question 10

MR/arthrography is used most frequently to ID tears of the:

Answer 10

acetabular labrum

Question 11

What sound head transducer do you use to observe the hip?

Answer 11

linear
lower frequency
2.5-5 MHz

Question 12

Inlet view

Answer 12

20 degrees caudally

good view of ring configuration of pelvis, posterior displacement of ring, opening of pubic symphesis

Question 13

Outlet view

Answer 13

20 degrees towards feet

good view of sacrum and crests

Question 14

Radiograph indicated with suspected stress fx?

Answer 14

conservative mgmnt first

then plain radiograph

Question 15

3 common developmental pathologies?

Answer 15

Slipped capital femoral epiphysis
Developmental dysplasia of the hip
Legg-Calve-Perthes

Question 16

SCFE, Slipped capital femoral epiphysis, incidence:

Answer 16

Boys between 12 and 15, girls between 10 and 13
Obesity can increase risk
Surgical intervention is pinning
Potential complications
Deformity of the hip
AVN

Question 17

Incidence of legg-calve-perthes:

Answer 17

The age of diagnosis is usually between 2 and 12 years old

Average age of 6

Question 18

4 stages of healing in legg-calve-perthes:

Answer 18

Femoral head becomes more dense with possible fracture of supporting bone;
Fragmentation and reabsorption of bone;
Reossification when new bone has regrown; and
Healing, when new bone reshapes.

Question 19

Treatment of legg-calve-perthes?

Answer 19

Treatment generally conservative

Surgery involves osteotomy, tenotomy

Question 20

What are the 3 types of developmental dysplasia?

Answer 20

Dislocated
Dislocatable
Subluxatable

Question 21

Cam lesion

Answer 21

overgrowth on femoral head

maybe pinch or bony end feel into end range flexion

Question 22

pincer lesion

Answer 22

acetabulum overgrowth