Minor trauma - the hip

Question 1

blood supply to neck and head of femur

Answer 1

medial circumflex artery (flexes around the NOF)

Question 2

interruption to the blood supply may lead to…

Answer 2

AVN (Avascular necrosis)

Question 3

how does blood supply risks impact on the radiographer’s role?

Answer 3

time-constraints to image pt

Question 4

Capital fracture

Answer 4

fracture through the head of femur

Question 5

sub-capital fracture

Answer 5

fracture beneath the head of femur. This has a risk of vascukar interuption

Question 6

intertrochanteric fracture

Answer 6

fracture that occurs between the greater and lesser trochanters

Question 7

Contributing factors to injury of the hip

Answer 7

Age
Limited mobility
Osteoporosis
high blood pressure
Arthritis

Question 8

osteoporosis

Answer 8

thinning of bones/ loss of mineral content

Question 9

patients affected by osteoporosis

Answer 9

menopausal women, older patients

Question 10

Mechanism of injury for Hip#

Answer 10

direct fall onto hip

high force trauma

Twisting mechanism where the foot is planted and the body rotates.

risk increased by unsteady gait

Question 11

types of hip fractures

Answer 11

subcapital, transcervical, intertrochanteric, subtrochanteric, fracture to the lesser trochanter, # to great trochanter

Question 12

Subcapital fracture

Answer 12

located under the head of femur

Question 13

transcervical fracture

Answer 13

through the NOF

Question 14

intertrochanteric fracture

Answer 14

between the trochanters

Question 15

subtrochanteric #

Answer 15

below the trochanters

Question 16

intra-capsular #

Answer 16

within the capsule of the hip joint

Question 17

types of intra-capsular #

Answer 17

subcapital and transcervical

Question 18

extra-capsular #

Answer 18

outside of capsule

Question 19

types of extra-capsular #

Answer 19

subtrochanteric and intertrochanteric

Question 20

how many stages are there in the Garden classification?

Answer 20

4

Question 21

what # does the garden classification include?

Answer 21

sub-capital or transcervical

Question 22

garden stage 1

Answer 22

incomplete # and undisplaced (STABLE)

Question 23

Garden stage 2

Answer 23

complete # and undisplaced (STABLE)

Question 24

Garden stage 3

Answer 24

complete fracture and partially displaced (UNSTABLE)

Question 25

Garden stage 4

Answer 25

complete fracture and completely displaced (UNSTABLE)

Question 26

how are garden stages 1 and 2 treated

Answer 26

with the use of internal fixation (head preservation) e.g. dynamic hip screw

Question 27

how are garden stages 3 and 4 treated

Answer 27

treated with arthroplasty (Hemi- or total arthroplasty e.g hip replacement)

Question 28

imaging techniques AP hip trauma

Answer 28

AP pelvis - some departments may not include crests

Question 29

shenton's line

Answer 29

line continues from the inferior border of the femoral neck to the inferior border of the pubic ramus. any interruption in the line suggests an abnormal position of femoral head

Question 30

centring point for HBL hip

Answer 30

o perineal crease, in midline of the femur with a horizontal

Question 31

Technical considerations for hbl

Answer 31

femoral head needs to be demonstrated in relation to the acetabulum

Question 32

challenges to consider for hbl imaging

Answer 32

patient's condition, positioning, time spent and radiation protection

Question 33

condition of patient includes

Answer 33

age, distress, confusion, fear

Question 34

NICE Guidelines 2017 Hip Fracture: management

Answer 34

Offer (MRI) if hip fracture is suspected despite negative X‑rays of the hip of an adequate standard. If MRI is not available within 24 hours or is contraindicated, consider CT

Question 35

Other non-imaging tests to be performed

Answer 35

observation e.g. bp, pulse, temperature, ECG, oxygen sats, inr

Question 36

pathway for those under 65