Lecture 1 - Femur and Hip

Question 1

Explain the angulation of fem shaft and its variations in people

Answer 1

slants 5-15 deg medially

• depends on breadth of pelvic girdle
• ie. angle increased when fem head is separated by broad pelvis

this angulation is noticed by the unlevelled femoral condyles when shaft is held vertically

Question 2

What are the effects or internal external rotation of leg on bony landmark visuals?

Answer 2

internal = GT prominet and fem neck

external = LT prominent

Question 3

describe the femoral head orientation in the acetebulum?

Answer 3

angled 15 deg posterorly in ace

Question 4

What if there’s no fracture shown on xray but there’s still symptoms of frac?

Answer 4

do MRI

if not avial, do CT or bone scan

Question 5

What are the technichal factors considered before imaging pt

Answer 5

length of femur

look at pts prev scans (if they have had any)

is the request justified?

preggo?

Question 6

What to do when whole length of femur doesn’t fit onto a 35x43 cas?

Answer 6

complete two images of same projection

• there will have to be a slight overlap of 1cm or so to not lose any anatomy

Question 7

What projections of the femur can be done?

Answer 7

AP proximal femur

AP distal femur

mediolateral proximal femur

mediolateral distal femur

TRAUMA

• AP PELVIS
• AP FEMUR (DISTAL OR PROX)
• HBL PROX FEMUR (AXIOLATERAL)
• if necessary doe HBL DISTAL FEMUR

Question 8

AP FEMUR

Answer 8

tech:

• 35x43 portrait (femur vertical)
• exp: 70 kVp, 25 mAs (varied with size)

pos:

• position upper edge of IR at level of ASIS
• rotate leg internally to see neck with no foreshorteing

beam:
- mid femur

Question 9

MEDIOLATERAL FEMUR

Answer 9

if femur doesn’t fit onto one, do two images with overlap of min 5cm

tech:

• 35x43 portrait (femur positioned horioztal across IR)
• out of bucky

pos:

• supine
• roll pt onto affected side until femoral epicondyles perp to table

beam:
- mid femur