Download Hip and Pelvis

Hip and Pelvis
Chapter 6
Hip AP
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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