Hip and Pelvis Flashcards
2 hip bones
•Sacrum
•Coccyx
Hip bone
•Os coxae, coxal, or innominate bones
•Comprised of ilium, ischium, and pubis
Acetabulum of the hip is the
-Deep cup shaped depression on the lateral aspect of each hip bone
-Made up of the ilium, ischium, and pubis
The Obturator Foramen is the
•Large, oval shaped opening on inferior aspect of each coxal bone
•Formed by pubis and ischium
Joints of the Pelvis and Hip
Sacroiliac joint
•Synovial Gliding
Hip Joint
•Synovial Ball and Socket
Pubic Symphysis
•Cartilaginous symphysis
Pelvis AP IR, Position, CR
IR: 14x17 CW
Top of IR usually 1-1.5” above iliac crests
Position:
•Supine with MSP centered
•Medially rotate the legs 15-20º (unless fractured)
•Pelvis is not rotated
CR: Perpendicular to IR
Midway between ASIS and pubic symphysis
Collimation: 14x17
Respiration: Suspend
Pelvis AP Evaluation Criteria
-Entire pelvis and proximal femora
-Both ilia and greater trochanters equidistant to edge of the image
-Lower vertebral column centered
-No rotation of pelvis:
•Both ilia symmetric
•Symmetric obturator foramina
•Ischial spines equally seen
•Sacrum/Coccyx aligned
-Proper rotation of femora:
•Femoral necks
•Greater trochanters in profile
For the hip and pelvis images ALWAYS include…
Entire length of hardware/appliance
If leg is shorter than the other and resting on the side it could mean…
Fracture, do NOT rotate
Hip AP IR, Position, CR, Collimation
-IR: 10x12 LW
-Position: Supine
•No rotation of pelvis (ASIS equidistant to table)
•Medially rotate the affected leg 15-20º (if no fracture/dislocation)
-CR: Perpendicular to the femoral neck
•2.5” distal on a line drawn perpendicular to the midpoint of a line between the ASIS and the pubic symphysis
•Alternative:
1-2” medial and 3-4” distal to ASIS
-Collimation: 10x12
-Respiration: Suspend
Hip AP Evaluation Criteria
-Hip joint with ilium and pubic bones
-Proximal one third of the femur
-Entire long axis of femoral neck not foreshortened
-Greater trochanter in profile
-Lesser trochanter usually not projected beyond the medial border of the femur
-Any orthopedic appliance in its entirety
Hip AP Oblique Modified Cleaves (Unilateral) IR, Position, CR, Collimation, Respiration
-IR: 10x12 CW
-Unilateral Hip Position:
•Center ASIS of affected side
•Flex knee, draw foot up to the opposite knee
•Abduct thigh laterally to 45º
-CR: Perpendicular to the femoral neck
-Collimation: 10x12
-Respiration: Suspend
Hip AP Oblique Modified Cleaves (Bilateral) IR, Position, CR, Collimation, Respiration
-IR: 14x17 CW
-Bilateral “Frog Leg” Position:
•Flex hips and knees to bring femora in vertical position
•Center 1” superior to pubic symphysis at MSP
•Abduct thigh laterally to 45º and place soles of the feet together
-CR: Perpendicular entering the MSP at the level 1” superior to the pubic symphysis
-Collimation: 14x17
-Respiration: Suspend
Hip AP Oblique Modified Cleaves Evaluation Criteria
-No rotation of pelvis
Acetabulum, femoral head, and femoral neck
-Femoral neck without superimposition by greater trochanter
-Lesser trochanter on the medial side of the femur
Hip Lateral (Lauenstein Method) IR, Position, CR, Collimation, Respiration
-IR: 10x12 CW
-Position:
•From supine, rotate toward affected side
•Flex knee and draw thigh up to right angle to hip
•Body of femur parallel to the table
•Rotate pelvis no more than necessary
-CR: Perpendicular to the hip joint
•Midway between ASIS and the pubic symphysis
-Collimation: 10x12
-Respiration: Suspend
Hip Lateral(Lauenstein method) Evaluation Criteria
-Hip joint centered
-Hip joint, acetabulum, and femoral head
-Femoral neck overlapped by greater trochanter
The Hip Lateral is used to show the relationship of…
The femoral head to acetabulum
What view do you do if patients hip is fractured?
Hip axiolateral aka the Danelius Miller Method
Hip axiolateral (Danelius Miller Method) IR, Position, CR, Collimation, Respiration
-Cross table or surgical lateral
-IR: 10x12 LW grid cassette
-Position: Supine
•Elevate patient
•Flex knee/hip of unaffected side and rest on sponge or leg holder
-CR: Perpendicular to the femoral neck
•Enters groin midway between the anterior and posterior surfaces of the thigh
-Collimation: 10x12
-Respiration: Suspend
Hip axiolateral (Danelius Miller Method) Evaluation Criteria
-Hip joint with acetabulum
-Femoral neck without overlap from the greater trochanter
-Small amount of lesser trochanter on the posterior surface of femur
-Small amount of greater trochanter on the ant/post surfaces of the proximal femur
-Ischial tuberosity below the femoral head and neck
-Any orthopedic appliance in its entirety
What if patient can’t raise unaffected side of the hip?
Hip: modified Axiolateral Clements-Nakayama modification
Projection used for bilateral hip fractures or patient is unable to move unaffected side?
Hip: modified Axiolateral Clements-Nakayama modification
The Axiolateral Danelius Miller method is used for ________ patients
Trauma
Hip axiolateral (Danelius Miller Method) has the same evaluation criteria as the…
Hip: modified Axiolateral Clements-Nakayama modification
