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Hip and Pelvis Chapter 6 Hip AP • • • • Facility Identification Correct Marker Placement No Preventable Artifacts Correct Film Size (10 x 12 lw unless indicated) Hip AP • Density – Controlled by mAs – Overall the density is not too dark or too light • Contrast – Optimal kVp 75-85 – Bony trabecular patters and cortical outlines visualized as well as soft tissues (fat pads) of the hip are demonstrated Hip AP • Pelvis is in true AP projection – The ischial spine is aligned with the pelvic brim – The sacrum and coccyx are aligned with the symphysis pubis – The obturator foramen is open Hip AP • Detecting rotation toward the affected hip • If the ischial spine is demonstrated without pelvic brim superimposition • The sacrum and coccyx are rotated away from the affected hip • The obturator foramen is narrowed Hip AP • Detecting rotation away from the affected hip • The sacrum and coccyx are rotated toward the affected hip • The ischial spine is closer to the acetabulum • The obturator foramen is widened Hip AP • The femoral neck is demonstrated without foreshortening – The greater trochanter is demonstrated in profile laterally – The lesser trochanter is superimposed by the femoral neck Hip AP • The femoral head and acetabulum are in the center of the collimated field • Any orthopedic appliance are located at the hip are included in their entirety. Hip AP • Gonadal shielding should be used on all males and females if it may be placed so that anatomy is not obstructed Hip Frog leg Lateral • The pelvis is in a true AP position – The ischial spine is aligned with the pelvic brim – The sacrum and coccyx are aligned with the symphysis – The obturator foramen is open Hip Frog leg Lateral • The lesser trochanter is demonstrated in profile medially • The femoral neck superimposes the greater trochanter – The neck if foreshortened and is ½ way between the femoral head and the lesser torchanter Hip Axiolateral Danielus Miller • Placing lead flat contact shields over the unused portion of the cassette will reduce scatter and help improve contrast Hip Axiolateral Danielus Miller • The femoral neck is demonstrated without foreshortening • The greater and lesser trochanters are about the same transverse level Hip Axiolateral Danulus Miller • If the angle formed between the femur and the central ray is too large, the trochanter is demonstrated proximal to the lesser trochanter and is superimposed by a portion of the femoral neck • If the angle is too small, the greater trochanter is demonstrated distal to the lesser trochanter. (this seldom occurs due to table top) Pelvis AP • Pelvis is demonstrated without rotation – The ischial spines are aligned with the pelvic brim – The sacrum and coccyx are aligned with the symphysis – The ilia and the obturator foramina are uniform in size and shape Pelvis AP • Male –vs- Female Pelvis – Male pelvis is more heart shaped • The obturator foramina and acetabula are larger and more bulky – Female pelvis is more oval Pelvis AP • The femoral neck is demonstrated without foreshortening – The greater trochanter is demonstrated in profile laterally – The lesser trochanter is superimposed by the femoral neck Pelvis AP • Detecting rotation toward the affected hip • If the ischial spine is demonstrated without pelvic brim superimposition • The sacrum and coccyx are rotated away from the affected hip • The obturator foramen is narrowed Pelvis AP • Detecting rotation away from the affected hip • The sacrum and coccyx are rotated toward the affected hip • The ischial spine is closer to the acetabulum • The obturator foramen is widened Pelvis AP • All anatomy is included on the film – Inferior sacrum is in the center of the film – The ilia, symphysis ischia acetabulum, femoral necks and heads, greater and lesser trochanter are included on film THE END