Radiography - Pelvis Flashcards
First line imaging modality for assessing both the male and female pelvic viscera
Ultrasound
Used to assess pelvic vasculature
Doppler Ultrasound
Why is CT scan not advised for pelvic imaging? When is it used in the pelvic?
> Due to radiation exposure to the gonads
> except in the setting of trauma
Operator dependent imaging
Ultrasound
What special feature is in doppler ultrasound?
Color codes fluid moving away and towards a certain area
Visualizes in multiple planes
CT scan
Superior soft tissue contrast resolution for imaging the anatomy
MRI
Ultrasound:
(1) Dark image
(2) Light image
(1) fluid
(2) more dense; bone - homogenous lightest,
tissue - heterogeneous light to gray
Best type of MRI on:
(1) anatomy imaging
(2) pathological
(1) T1-weighted
(2) T2-weighted
Gold standard modality for assessing pelvic vasculature
Angiography
What appears bright on T1-weighted MRI images
Fat
What appears bright on T2-weighted MRI images
Fluid filled structures
(True or False)
MRI does not use radiation
True
How to check if there is normal coverage of femoral head by the acetabulum?
Center-edge angle (cea)
Female pelvis
- wider/circular pelvic inlet
- wide pelvic outlet
- cylindrical pelvic cavity
- more than 90 degrees infrapubic angle
Male pelvis - describe differences with female
- heart shaped/narrow pelvic inlet
- narrow pelvic outlet
- funnel shaped pelvic cavity
- v-shaped pubic arch
Pelvic view of X-ray tilted 45 degrees caudally at patient lying prone
Inlet view
Pelvic view of X-ray tilted cranially on patient lying prone
Outlet view
Disrupted shenton line indicates
- Hip dislocation
- femoral neck fracture
Happens when a bone fragment separates from the rest of the bone
Avulsion fracture
Pubococcygeal line (PCL)
line that connects inferior margin of the symphysis pubis to coccyx
Where organs should NOT be crossing during valsalva
Normal H-line
line from inferior margin of pubic symphysis to the posterior aspect of the anorectal junction
Normal < 5cm
M-line (muscular pelvic floor relaxation)
runs perpendicular from the PCL to the lowest aspect of the H-line
Normal <2cm
longer line indicates anorectal descent - pathological
Anorectal angle Normal range:
108 to 127 degrees at rest
Bulge beyond the anterior rectal line
Rectocoele
Female sacrum
more triangular and shorter
Borders for pelvic brim or pelvic inlet
- ant: pubic crest, pectin pubis
- laterally: arcuate line (of the ilium)
- post: sacral ala
Pelvic outlet borders
- ant: pubic arch, inferior margin of the pubic symphysis, pubic rami, ischial rami
- laterally: ischial tuberosities
*post-laterally: sacrotuberous ligaments
*post: sacrum, coccyx
Muscle attachment to:
iliac crest
abdominal muscles
Muscle attachment to:
ant. sup. iliac spine
sartorius
Muscle attachment to:
ant. inf. iliac spine
rectus femoris
Muscle attachment to:
Greater trochanter
gluteus med-min
Muscle attachment to:
lesser trochanter
iliopsoas
Muscle attachment to:
ischial tuberosity
hamstrings
Muscle attachment to:
Symphysis
Adductors
A hip condition that occurs in teens and pre-teens who are still growing.
For reasons that are not well understood, the ball at the head of the femur (thighbone) slips off the neck of the bone in a backward direction.
Slipped capital femoral epiphysis (SCFE)
A rare condition in which the ball-shaped head of the thighbone (femoral head) temporarily loses its blood supply.
As a result, the head of the thighbone collapses, and the area becomes inflamed and irritated.
Legg-Calve-Perthes disease (also known as Perthes disease)
Pelvic Cavity potential spaces where fluid can accumulate
- pelvic peritoneal space (rectouterine pouch/rectovesical pouch)
- retropubic space (of Retzius)
- paravesical space (-lateral fossa)
- presacral space
- canal of nuck
- pudendal canal
- obturator canal
Alcock’s canal
Pudendal canal
Normal presacral space
< 15mm at 45 yrs old or younger
Muscle Bone Attachments - Memorize
MRI - Functional Anatomic Compartments of a Female Pelvis
Imaging of body pelvis
