Pelvis, Hip Joint and Upper Third of Femur

6 Pelvis, Hip Joint and Upper Third of Femur

• Lateral (frog)

• Lateral – neck of femur

• AP – single hip

• Lateral – non-trauma

PELVIS

Projection: AP

Centring Point: Midline midway between the ASIS and the superior border of the symphysis pubis (photograph – solid while circle denotes ASIS)

Points to consider

Technique

Rotate the legs approximately 15° medially and support

Large patient – raise the SID to 120 cm to reduce magnification, but care with exposure and dose

Exposure – too high a mAs will blacken out the iliac fossa

Do not place arms by side – they may appear on the radiograph

Radiological assessment

Foreshortened femoral neck – inadequate medial rotation

Check obturator foramina are equal size and shape

Whole of the pelvis must be included on the radiograph

Check Shenton’s line – any disruption is due to a fractured neck of femur

Do not confuse epiphyseal lines with #s – iliac crest fuses late teens to early twenties

Note

Obliques of the pelvis may be required to demonstrate:

• On the raised side – iliac crest in profile and into the acetabular fossa

• On the non-raised side – iliac fossa opened out and the acetabulum in profile

AP

• Patient lies supine in the centre of the table

• ASIS must be equidistant from the table top

• Both knees are very slightly flexed and supported by non-opaque pads

• Heels are separated and the limbs are rotated internally until the toes are touching. NB Should not be forced in a trauma situation

Collimation

To include: SUPERIORLY: Body of fifth lumbar vertebra and iliac crests

INFERIORLY: Proximal femurs

LATERALLY: Soft tissue borders

Tags: Pocketbook of Radiographic Positioning

Mar 6, 2016 | Posted by admin in GENERAL RADIOLOGY | Comments Off

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