Pelvic Girdle

Pelvic Girdle

1st year 1st quarter

*AP affected hip

**If this is the initial exam of the hip you might need to take a AP pelvis instead of a AP hip

*Lateral affected hip

HIP

Structures shownAP Hip

• Head, neck, trochanters and proximal one third of the body of the femur. *The pubic symphysis must be shown on one view of the hip

Good Film

• Lower portion of the ilium and pubic symphysis should be included on the film.

• Any orthopedic appliance should be included in its entirety

• The greater trochanter should be in profile• The long axis of the femoral neck should be seen• The proximal third of the femur should be

included• Little or none of the lesser trochanter should be

visible beyond the medial edge of the femur

Neck

Lesser trochanter

pubic symphysis

greater trochanter

AP Right Hip

Bursitis

AP Right Hip

AP left Hip

Bone graft

OUCH!

Structures shownLateral hip(mediolateral Lauenstein method)

• A lateral projection of the hip is demonstrated, showing the acetabulum, the proximal end of the femur, and the relationship of the femoral head to the acetabulum

Good Film

• ***Don’t do this view if fracture is likely or patient is post-op for less than three days.

• The hip joint should be centered to the film.

• The hip joint, acetabulum, and femoral head should be well demonstrated.

Hip pinning

Lateral Right Hip

End of hardware

Plug

Lateral Right Hip

Extra boneformation after surgery

Lateral Right Hip

Lateral Left Hip

Lateral Right Hip

Pediatric Patients: Congenital Hip Abnormalities

• AP pelvis

• Modified Cleaves (***not done if fracture is suspected)

Diaper

“Frog legs”

ModifiedCleaves method

For pediatric patients with congenital hip abnormalities

Structures shownAxiolateral Hip (Danelius-Miller)

• Axiolateral projection of the acetabulum and the proximal femur to include the head, neck, and trochanters. *** This view is done to see the neck

Good Film:

• Do this view if fracture is likely or patient is post-op.• As much of the femoral neck should be seen as possible

without overlap from the greater trochanter• Only a small amount of the lesser trochanter should be

seen on the posterior surface of the femur• A small amount of the greater trochanter should be seen on

the anterior and the posterior surfaces of the proximal femur (when it is safe for the femur to be inverted)

• The soft tissue shadow of the unaffected thigh should not overlap the hip joint or proximal femur.

• The hip joint with the acetabulum should be included .

Greatertrochanter

Soft tissue

neckOther leg

X-Table Lateral Lt Hip

Don’ forget you might have to build your Pt up !

X-Table Lateral Rt Hip

RT

Other leg in the way!

X-Table Lateral Rt hip

Judet’s method

• RPO

• LPO

Structures shown: The acetabular rim

• We want AP oblique position to include both hips on each film.(always do both obliques) The whole pelvis should be included. The iliac wing is also well visualized.

Different than Merrill’s:

Why would you do them?

• Used to demonstrate fractures of the posterior (ilioischial) column and anterior rim of the acetabulum.

L

Rt Hip Down: RPO

Left Hip Down :LPO