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MODULE 7 HIP HIP: NORMAL ANATOMY AND POSITIONING Three views • AP • Lateral • Frog Leg LINES OF MENSURATION Teardrop distance Maximum of 11.0mm, minimum of 6.0mm, with an average of 9.0mm Waldenstrom sign Fig 3-48A Teardrop distance Fig 3-48A Increased Teardrop distance LINES OF MENSURATION Hip joint space width Three measurements • superior • axial • medial (aka - teardrop) Pattern of collapse is very important to note Hip joint space width LINES OF MENSURATION Acetabular Depth <7.0mm in males and 9.0mm in females Dysplasia has an intact joint space Rheumatoid arthritis has a loss in joint space Acetabular Depth Fig 3.50a LINES OF MENSURATION Center-edge angle Represents “coverage” of femur head by acetabulum Minimum of 20o, maximum of 40o, with an average of 36o Center-edge angle Fig 3.51a LINES OF MENSURATION Symphysis Pubis Width Increased width is indicative of cleidocranial dysplasia, bladder exostrophy, HPT, trauma - diastasis, osteolysis ankylosing spondylitis, osteopubis, gout Symphysis Pubis Width Fig 3.52a Symphysis Pubis Width Fig 3.52b LINES OF MENSURATION Acetabulur angle Minimum 12o, maximum 29o, with an average of 20o Increased angle is indicative of dysplasia, congenital hip dislocation Decreased angle is indicative of Down’s syndrome Acetabulur angle Fig 3.54 LINES OF MENSURATION Protrusio acetabuli (Kohler’s line) Femur head should be lateral If acetabulum floor crosses line - idiopathic, rheumatoid arthritis, Paget’s (osteomalacia) Kohler’s line Fig 3.57b
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