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Chapter 8 Hip and Pelvis Proximal Femur • __________ – Round process • _________ – Depression in the center of the head • ________ – Area between shaft and head • ____________ – Cavity for head of femur Proximal Femur • _______________ – Superiolateral prominence • ______________ – Medioposterior prominence inferior to greater trochanter. • ________________ – Depression between trochanters Femur Angle • Not _________ • Angle of positioning importance – Head and neck = _______________. • Rotate legs ________________to get neck in true AP Hip Imaging Routine • AP Pelvis • Lateral – Frog Leg – X-table lateral • AP Unilateral Hip • 40” SID • 75 kVp AP Pelvis • Pt Supine • _____________________(Pigeon Toe) • Center Midline between ______and _______________ • Top of Cassette ____________Crest • Collimate to skin • If Trauma __________________***** Frog leg Lateral • • • • Pt Supine Flex knee and ________________ A sponge may help Center to Femoral Neck – Draw imaginary line between ______ and __________and go inferior _______perpendicular to line X-table Hip • Pt Supine • Do not move affected Hip • Unaffected Leg _____________. Can put leg on collimator • Use X-table grid parallel to __________ • Adjust collimator to be perpendicular to cassette. AP Hip • • • • Patient Supine Rotate Leg ______________ CR directed ___________to femoral neck __________and _________to ASIS Pelvis • Connects _________________to the axial skeleton • Consists of – ___________ – 1 sacrum – ______________. • Pelvic girdle – ______________only Hip Bones • _________ • Ischium • ___________ • Acetabulum – The area of fusion for the 3 bones. Ilium • _________ – Large winged area • ____________ – Inferior to the Ala. Includes superior acetabulum • _____________ • ASIS, AIIS, PSIS, PIIS. Ischium • Inferioposterior to acetabulum. • ___________ – Posterior acetabulum to ischial tuberosity • ____________ – Anterior portion off of ischial tuberosity Ischium • ________________ – Rounded, rough area at the border of lower body and Ramus • _______________ – Posterior bony protrusion off acetabulum • ______________ sciatic notch – Depression superior and inferior to ischial spine Pubis • Anterioinferior to acetabulum. • ___________ – Anteriorinferior acetabululum to superior ramus • ______________ – Anterior medial extensions meeting to form symphysis pubis. • _____________ – Inferioposterior extension off symphysis pubis to Ischial Ramus • _______________ – Hole formed by ischium and pubis True and False Pelvis • True (Lesser) – Area surrounded _________ – _______ to pelvic brim – _______ – Inlet and Outlet • False (Greater) – Area formed by ________ – __________ to pelvic brim Male vs. Female Pelvis • Male – ________ – Deeper – ______ – Lesser pubic arch – Narrow inlet – Oval ________Foramen • Female – _______ – More Flared – Greater ________ – Larger inlet – Narrow Obturator Foramen Joints of the Pelvis • ______________ – Amphiarthrodial Synovial, Sacrum to pelvis • _______________ – Amphiarthrodial cartilaginous. Rt and Lt pubic bones • Union of Acetabulum – Synarthrodial cartilaginous. 3 fused hip bones • Hip Joint – Diarthrodial Synovial Spheroid. Imaging the Pelvis Routine • • • • AP 14 x 17 XW 40” SID 75 kVp AP Pelvis • Pt Supine • ___________legs 15° (Pigeon Toe) • Center Midline between ______ and _______________ • Top of Cassette 1 to 2” above Crest • Collimate to skin • If Trauma do not rotate legs ***** Sacroiliac Joint Imaging • Place patient into ________________ • The joint of interest is elevated – _____________SI joint • Direct CR ___________to upside ASIS
