Pelvis Hip PP Flashcards
What must be included in the final image for pelvis and hip examinations?
Right or left side markers and other required ID markers
Avoid using digital annotation to place side markers on images.
What is the standard SID for pelvis and hip examinations?
40 inches
SID stands for Source-to-Image Distance.
What collimation size is required for a pelvis examination?
14 x 17 inches (35 x 43 cm) and 1 inch (2.5 cm) beyond the skin shadow on the sides for smaller patients.
What collimation size is required for a hip examination?
10 x 12 inches (24 x 30 cm)
During what phase should exposures be taken?
Suspended respiration
What are the general patient positions for ambulatory and nonambulatory patients?
Ambulatory: Supine on x-ray table; Nonambulatory: Use proper transfer techniques to table or use grid IR if transfer is not possible.
What artifacts should be removed from the anatomy of interest?
Undergarments, clothing
Provide a gown for the patient.
What does the general procedural guidelines for pelvis and hip examinations include?
Patient preparation, general patient position, respiration, IR/collimation size, SID, ID markers, radiation protection, patient instructions.
What should be explained to the patient before the examination?
Positions and breathing instructions; respirations are suspended for exposure.
What is the patient position for the AP oblique femoral necks (modified Cleaves)?
Supine with MSP centered to IR, no rotation of pelvis, ASIS equal distance from tabletop, flex hips and knees, abduct thighs approximately 45 degrees.
What evaluation criteria should be met for an AP pelvis and upper femora?
No rotation of pelvis, symmetric ilia, symmetric obturator foramina, ischial spines equally seen, proper rotation of proximal femora.
What structures are shown in an AP pelvis and upper femora examination?
Pelvis and the head, neck, trochanters, and proximal one-third or one-fourth of the femur.
What is the central ray direction for the AP pelvis and upper femora?
Perpendicular to IR, 2 inches (5 cm) inferior to ASIS and 2 inches (5 cm) superior to pubic symphysis.
What angle does the femoral neck project from the body in an average adult?
15-20 degrees anteriorly and 120-130 degrees superiorly.
What are the three bones that form the acetabulum?
Ilium, ischium, pubis.
What is the proper positioning of the lower limbs for the AP projection of the pelvis?
Medially rotated 15 to 20 degrees.
What are the components of the hip bone?
Pubis, ilium, ischium.
What is the function of the pubis in the hip bone?
Forms approximately one-fifth of anterior acetabulum.
Which anatomical landmarks are important for localizing the hip joint?
Iliac crest, ASIS, pubic symphysis, greater trochanter, ischial tuberosity, tip of coccyx.
Which projection requires the patient to abduct the thighs 45 degrees laterally?
AP oblique femoral necks (modified Cleaves).
What should be centered to the midline of the grid for the superoinferior axial inlet anterior pelvic bones?
MSP.
What is the central ray direction for the AP axial outlet anterior pelvic bones for men?
Angle 20-25 degrees cephalad.
What type of joint is the pubic symphysis?
Cartilaginous, slightly movable joint.
What is the highest point of the greater trochanter aligned with?
Midpoint of the hip joint and coccyx.
What is the significance of the intertrochanteric crest?
It is a prominent ridge located posteriorly between the trochanters at the base of the neck.
Which examination method is contraindicated if fracture or pathology is suspected?
AP oblique (modified Cleaves method).
What is the average angle of the femur in children compared to adults?
Wider angle in children (neck more vertical) compared to adults.
What is the Axiolateral hip projection also known as?
Danelius-Miller method
This method is used for imaging the hip joint.
What does the AP oblique acetabulum projection refer to?
Judet method
This method is used to visualize the acetabulum in an oblique position.
What is the purpose of the AP oblique femoral necks projection?
Modified Cleaves method
This method is used to obtain images of the femoral necks.
Identify the projection for the lateral hip using the Hickey method.
Lateral hip (Hickey)
This method provides a lateral view of the hip joint.
Identify the projection for the lateral hip using the Lauenstein method.
Lateral hip (Lauenstein)
This method is another approach for lateral imaging of the hip.
What is the central ray direction for a bilateral pelvis projection?
Perpendicular to MSP at level 1 inch (2.5 cm) above pubic symphysis
MSP stands for mid-sagittal plane.
What is the radiation field size for a bilateral pelvis projection?
14 × 17 inches (35 × 43 cm) crosswise
This field size is used for proper coverage of the pelvis.
What structures are shown in an AP hip projection?
- Head
- Neck
- Trochanters
- Proximal one-third of the body of the femur
These structures are essential for assessing the hip joint.
What is the required patient position for the AP hip projection?
Supine
The pelvis should not be rotated.
In the AP oblique acetabulum projection (Judet), what is the patient position?
Recumbent posterior oblique position (RPO or LPO) with affected hip up
This positioning helps visualize the acetabulum.
What is the purpose of the collimation in radiographic projections?
To limit radiation exposure and focus on the area of interest
Proper collimation is critical for image quality.
What is the central ray entry point for the AP oblique acetabulum projection?
2 inches (5 cm) inferior to ASIS of affected side
ASIS stands for anterior superior iliac spine.
What is the evaluation criterion for the Lauenstein method?
- Evidence of proper collimation
- Regions of the ilium and pubic bones
- Hip joint
- Proximal one-third of the femur
- Femoral head visible through the acetabulum
- Entire long axis of femoral neck not foreshortened
- Greater trochanter in profile
- Bony trabecular detail
These criteria ensure the quality of the radiographic image.
What is contraindicated in the Lauenstein method?
Fracture or pathology
This method should not be used if such conditions are suspected.
What is the central ray direction for the lateral hip (Hickey) method?
Cephalic angulation of 20 – 25 degrees entering 1 inch (2.5 cm) inferior
This angulation helps visualize the hip joint.
What is the patient position for the Axiolateral hip projection?
Supine with pelvis elevated for thin patients
The unaffected limb’s knee and hip should be flexed.
