Hip test Flashcards
What are the two holes on the pelvis called?
Obturator foramina
What is the large hole called?
Cavity or inlet or true pelvis
4 parts of the hip bone
Ilium on top
Ischium on outer
Pubis inner
Acetabulum is where femur head sits and where previous three meet
What is another name for the iliac wing?
Ala
What are the two sections of the pubis?
Superior ramus and inferior ramus
What is the section on the ischium that is to the right of the inferior ramus on the pubis?
Ischial tuberosity
Eval criteria for AP pelvis
Entire pelvis and proximal femoral included
No rotation of pelvis
Lesser trochanters not visible (or minimal)
How to do bilateral modified cleaves projection
Abduct femora 20-30 degrees-less distortion of femoral neck
CR 3 inches below level of ASIS
Eval criteria for modified cleaves
Pelvic girdle centered horizontally
No rotation of pelvis
Lesser trochanters equal in size
Great trochanters superimposed over femoral neck
Eval criteria AP unilateral hip and proximal femur
Proximal 1/3 of femur included
Hip joint space and acetabulum visualized
Lesser trochanters not visible
What happens to the femoral neck on a frog leg projection when the leg is abducted at 90 degrees?
The femoral neck is forshortened
What is best degree of abduction of leg for frog method?
30 degrees
What projections do you do for suspected fracture or dislocation of pelvis?
Limited AP and axiolateral (danelius-Miller)
Injury that occurs on the opposite side of impact?
Contrecoup
If laying on back and one foot splayed out when other is normal what does that mean?
Fracture of hip
When do you do bilateral modified cleaves?
Children with hip dysphasia
What position shows the anterior ilioichial column and posterior rim?
LPO downside Judet
What position shows posterior ilioschial column and anterior rim?
RPO downside
How position AP axial inlet projection?
CR 40 degrees caudad (toward feet) at level of ASIS
Eval criteria for AP axial inlet
Ischial spines demonstrated and equal
Pelvic inlet centered
How do AP axial outlet projection?
CR cephalad (toward head) 20-35 (males) or 30-45 (females)
CR centered 2 inches distal to symphysis pubis
Eval for AP axial outlet
Elongated and magnified pubic and ischial bones
No rotation of pelvis
Pubic and Ischial bones centered to collimation field
Condition that occurs when there is loss of blood to the bone
Avascular necrosis (AVN) Or aseptic necrosis
Most commonly occurs in hip
Axiolateral (inferosuperior) danelius-Miller method
CR perpendicular to midfemoral neck
IR parallel to alignment of anatomic neck
Eval criteria for danelius-Miller
Entire femoral head, neck, and acetabulum visualized
No visible grid lines
Compensating filter recommended
What is a dislocated joint called in the hip?
Hip dysplasia
Caused by shallow acetabulum
Baby-children
AP axial SI joints projection
CR 30-35 degrees cephalad
CR 2 inches below level of ASIS
Eval criteria AP axial SI joints
Sacroiliac joint center to collimation field
SI joint spaces and L5-S1 Junction open
Posterior oblique SI joints
Elevate affected side 25-30 degrees (oblique)
CR perpendicular 1 inch medial to ASIS
Eval criteria posterior oblique SI joints
Sacroiliac joints of interest open
Ala of ilium not overlapping over sacrum
Xiphoid process at what spine level?
T9-T10
Sternum parts top to bottom
sternoclavicular joint Manubrium Stern AP angle Body Xiphoid process
Spine level of jugular notch
T2-T3
Spine level of sternal angle
T4-T5
Spine level of costophrenic angles
L2-L3
True ribs
1-7
False ribs
8-12
Floating ribs
11-12
What connects ribs 1-10 to the sternum? (The anterior end of the rib)
Costal cartilage
What position best demonstrates the sternum?
RAO
With orthostatic breathing
RAO sternum projection
15-20 degree RAO
CR 1 inch left of midline midway between jugular Mitch and xiphoid process
Eval criteria for RAO sternum
Entire sternum visualized
Superimposed over heart
Correct rotation
PA sternoclavicular joints projection
True PA
CR perpendicular to T2-T3 (3 inches distal to vertebra prominens)
Eval criteria for PA SC joints
Medial portion of clavicles and SC joints visualized
No rotation
Anterior oblique RAO for right SC joint
10-15 rotation
CR level to T2-T3
Eval criteria for RAO
Manubrium and medial clavicle visible
SC joint open and shifted away from spine
Right SC joint demonstrated
Ribs AP above diaphragm
CR 3-4 inches below jugular notch
Expose on full inspirations
Erect preferred
Eval criteria AP ribs above diaphragm
1st to 10th posterior ribs visualized above diaphragm
No motion
No rotation
AP ribs below diaphragm
CR midway between xiphoid process and lower ribs
Recumbent preferred
Expose on expiration
Eval criteria AP ribs below diaphragm
9-12 ribs visualized
No motion
No rotation
Best positioning for axillary ribs
Rotate spine away from area of interest to elongate
Flail chest
Segment of rib case breaks due to trauma and becomes detached from chest wall. Produces paradoxical movement. When inhale the segment sinks inward. When exhale is bulges outward. (Opposite of normal)
Sternal deformities
Pectus excavatum (concaved chest)
Pectus carinatum (cartilage growth)
How many degrees is the proximal femur rotated internally for AP hip to overcome anteversion?
15-20 degrees
Line between greater and lesser trochanters on femur?
Intertrocanteric crest
CR for AP pelvis
Midway between ASIS and symphysis pubis
The ilia articulate with the sacrum posteriorly at the?
Sacroiliac joint
How many degrees of rotation are needed for an oblique projection of the ribs?
35-40 degrees
How many ribs attach directly to the sternum?
7
How much is the body rotated for the PA oblique of the SC joint?
10-15 degrees
Which structures articulate to form the costovertebral joint?
Head of the rib, vertebral joint
Depression or pit in head of femur
Fovea capitis
Judet: downside vs upside shown
Downside: RPO: anterior rim and posterior (ilioischial) column
Upside: LPO: posterior rim and anterior (iliopubic) column
