pelvis & hip review Flashcards by Sunnie Roderique

when the femur is vertical, which condyle is considered lower

medial condyle

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anteriorly, what are the distal condyles of the femur separated by

patellar surface (trochlear groove)

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the hip bone is made up of what 3 bones

ischium, ilium, & pubis

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what is the name of the cup shaped socket that receives the head of the femur on the hip bone

acetabulum

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the body of the ilium forms how much of the acetabulum

2/5th superiorly

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list the four prominent projections found on the ilium

ASIS, AIIS, PSIS, PIIS

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what three parts does the pubis consist of

body, superior ramus, inferior ramus

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when the body is in a seated upright position, the weight of the body rests on what structures

ischial tuberosities

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what is the prominent ridge between the trochanters on the posterior surface of the body named

intertrochanteric crest

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the two common fracture sites in the elderly

femoral neck, intertrochanteric crest

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two other names for the hip bone

ossa coxae & innominate bones

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where does the iliac crest set on vertebrae

L4 - L5 interspace

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the pelvis consists of which 4 bones

2 hip bones, sacrum, & coccyx

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what is the name of the small depression located on the head of the femur

fovea capitis

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the pubic of the hip bones articulate with each other at the anterior midline of the body, forming a joint called ?

pubic symphysis

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the largest foramen in the body

obturator foramen

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for which projection of an individual hip should the unaffected hip be flexed and the thigh be raised out of the way of the central ray

axiolateral projection (danelius - miller)

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how many degrees should the feet & lower limbs be internally rotated for an AP pelvis radiograph

15-20 degrees

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the CR for an AP pelvis is directed perpendicular to the center of the IR , what is the entrance point

2’’ superior to the pubic symphysis
2’’ inferior of the ASIS

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what will be shown in profile of the lower limbs are in correct position for an AP pelvis

greater trochanter

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what is the CR angle for an AP projection of the hip

perpendicular

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unless suspected fracture, the lower limb and leg should be internally rotated for an axiolateral projection of the hip (danelius - miller) how many degrees of rotation are required

15 - 20 degrees

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what is the respiration phase for the AP projection of the pelvis

suspended respiration

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which of the following is an important and frequently used radiographic positioning reference point

anterior superior iliac spine (ASIS)

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the strongest bone in the body

femur

where is the IR centered for an AP pelvis

midway between the ASIS and pubic symphysis

T/F : a grid is recommended for hip radiography

true

T/F : it is important to include the entire prosthesis when examining a patient with a total hip replacement

true

true pelvis is also

lower, actual birth canal, “lesser” pelvis

the false pelvis is also

higher, “greater” pelvis, inlet part of pelvis where baby “cooks”

the trochanters are joined by a ridge called the

interchrochanter crest

the ilium makes up the ___ part of the acetabulum

superior (2/5th)

the area superior to the oblique plane through the pelvis brim is the greater or ___

false pelvis

a severe blow or trauma to one side of the pelvis that results in a fracture on the opposite side from the injury

pelvic ring fracture

general differences between the male and female pelvis

shape, angle of pubic arch, position of ischial spines

between right and left pubic bones , cartilaginous and is very limited movement or ampiarthrodial

symphysis pubis

between sacrum & ilium , synovial joint & irregular gliding

sacroiliac joints (SI)

the symphysis pubis is ___ inferior to the ASIS

3-4 inches

typical sign for a broken hip

leg turned external

pelvic ring fracture is best seen on

CT scan

good for joint abnormalities & can look at muscles and soft tissue in addition to x rays

MRI

best to demonstrate newborn hip dislocation and joint stability during movement of lower limbs

ultrasound

good for early evidence of bony pathology processes, infections, mets, or other primary malignancies. More sensitive and asses the physiologic aspect rather than the anatomic aspect

nuclear medicine

AP pelvis evaluation criteria

greater trochanters are visible & in profile , the lesser trochanters should not be visible at all or only the tips

AP axial outlet projection (taylor method) CR

males - 20-35 degrees cephalic females - 30-45 degrees cephalic

posterior oblique acetabulum (judet method) clinical indications

acetabulum fractures & pelvic ring fractures

posterior oblique acetabulum (judet method) CR for pelvic ring

perpendicular 2’’ inferior from the ASIS and 2” medial to upside ASIS

ilium posterior inferior part ends in the

greater sciatic notch

ischium consists of

body & ischial ramus

ischium body forms what of acetabulum

posterior 2/5 of acetabulum

the pubis consists of

body, superior ramus, inferior ramus

the pubis body forms what of acetabulum

1/5th of anterior acetabulum

the obturator foramen is formed by what

junction of ischial ramus & pubis inferior ramus

heavier, narrower, deeper angle at pubic symphysis is acute heart shaped inlet

male pelvis

wider, shallower, lighter angle at pubic symphysis is obtuse more oval or wide inlet

female pelvis

which palpable landmark is at the same level as the pubic symphysis

greater trochanter

the weakest part in the pelvis is the

symphysis pubis

CR angulation and direction for AP axial inlet

40 degrees caudal to level of the ASIS

striking sclerosis of the bones of the hand and wrist, generalized increased bone density of the lower spine, pelvis, and hips

osteopetrosis

when looking for congenital hip dislocation what projection is the most commonly performed

the bilateral modified cleaves

hip dislocations caused by conditions present at birth, causes repeated dislocations

hip dysplasia also called developmental dysplasia of the hip (DDH)

bilateral symmetric obliteration of the sacroiliac joints by way of fusing together, works it’s way up the spine also called “bamboo spine” , most common in males

ankylosing spondylitis

also called DJD (degenerative joint disease) sclerotic bone formation in the acetabulum is seen, most common type of arthritis and considered normal aging

osteoarthritis of the hip

aseptic or ischemic necrosis , first presents as a lip mostly in 5-10 year old boys. the head of the femur becomes flat, then fragments

legg- calve- perthes disease

the most common type of primary bone cancer , looks like punched out bone, lytic lesions of lucency

multiple myeloma

intertrochanteric fractures happen between

the greater & lesser trochanter along the ridge

resembles cotton wool on a radiograph, it is from an overproduction of bone that is very dense but also pliable

paget’s disease

joint movement type of the symphysis pubis

ampharthrodial

how much is the affected side rotated for the PA axial oblique projection (teufel method)

35-40 degrees

what projection is best suited for the patient with limited movement of both lower limbs to demonstrate a lateral perspective of the proximal femur

clements - nakayama method

SI joint are classified as what type of mobility

amphiarthrodial

hip joints are classified as

diarthrodial

which pathology usually occurs in 10 to 16 year old patients during rapid growth

slipped capital femoral epiphysis

where is the CR directed for the PA oblique projection - judet method for acetabulum with affected side down

perpendicular and centered 2 inches distal and 2 inches medial to downside ASIS

where is the CR directed for the PA axial oblique projection - teufel method for the acetabulum with the affected side down

perpendicular and centered 1 inch superior to the level of the greater trochanter , approximately 2 inches lateral to the MSP, CR angled 12 degree cephalad

what topographic landmark is most frequently used for positioning the pelvis

ASIS