Hip/pelvis Flashcards
AP view:
- pt position
- central beam location
- demonstrations
- pt position - supine with feet in 15 degrees IR
- central beam location - directed vertically toward mid portion of pelvis or femoral head
- demonstrations - iliac, sacrum, pubis, ischia, femoral head and neck, GT and LT
What are the limitations of an AP view?
- Acetabulum are partially obscured by overlying femoral head
- Frequently not sufficient to provide adequate eval of the sacral bone, SI joint, and acetabulum
What are the 6 lines that should be ID’d int he AP view of the hip?
- Iliopubic line
- Ilioischial line
- Teardrop
- Acetabular roof
- Anterior rim acetabulum
- posterior rim acetabulum
Ferguson view:
- pt position
- central beam location
- demonstrations
- pt position - supine with feet in 15 degrees IR
- central beam location - radiographic tube positioned 30-35 degrees cephalic, central beam toward mid portion of pelvis
- demonstrations - effective in eval injury to SI joints, pubic and ischial rami
Anterior oblique (judet) view:
- pt position
- central beam location
- demonstrations
- pt position - supine and affected hip anteriorly rotated 45 degrees
- central beam location - vertically toward affected hip
- demonstrations - iliopubic column and posterior lip of acetabulum
Posterior oblique (judet) view:
- pt position
- central beam location
- demonstrations
- pt position - supine and unaffected hip anteriorly rotated 45 degrees
- central beam location - vertically toward affected hip
- demonstrations - ilioishcial column, posterior lip of the acetabulum, and anterior acetabular rim
Frog-lateral view:
- pt position
- central beam location
- demonstrations
- pt position - supine with knees flexed, soles of feet together, and thighs maximally abducted
- central beam location - directed vertically 10-15 degrees cephalic to a point slightly above the pubic rami, or toward affected hip
- demonstrations - proximal femur and hip, femoral head, GT and LT
Groin lateral view:
- pt position
- central beam location
- demonstrations
- pt position - supine with affected extremity extended and the opposite leg elevated and abducted
- central beam location - cassette placed against affected hip on lateral aspect, central beam directed horizontally toward the groin with 20 degrees cephalic angulation
- demonstrations - anterior and posterior aspects of the femoral head and anterior rim of the acetabulum
Why would you want to use the groin-lateral view?
useful in evaluating A and P displacements of fragments in proximal femur fxs; demonstrates the angle of ante version of the femoral neck (25-30 degrees)
Where are the sites of the majority of avulsion fractures?
- Iliac crest (abdominals)
- ASIS (sartorius, TFL)
- AIIS (rectus femoris
- GT (gluten, gemellus, piriformis)
- LT (iliopsoas)
- Ischial tuberosity (hamstrings)
- Body of pubis and inferior pubis ramus (adductors and gracilis)
Unstable hemipelvic fracture; unilateral fx of superior/inferior pubic rami; disruption of ipsilateral SI joint
malgaigne fracture
- clinically recognized by shortening of LE
- AP radiograph
“sprung pelvis”; disruption of both SI joints, associated with separation of pubic symphysis
bilateral dislocation
- pelvic dislocation
- marked widening of pubic symphysis
What are the intracapsular femur fractures?
- involves head or neck; often results in osteonecrosis due to limited blood supply to proximal femur
1. Capital
2. Subcapital (common)
3. Trans- or midcervical
4. basicervical
What are the extracapuslar femur fractures?
- Intertrochanteric
2. Subtrochanteric
The trabeculae of the hip can help identify degenerative changes within the bone. How are the trabeculae of the hip aligned?
- lateral margin of GT, through superior cortex of neck, to head just above the fovea
- compressive trabeculae are vertically oriented
- to GT
- Ward’s triangle is in the middle
- trabeculae are aligned with trabeculae within acetabulum
