pelvis and hip all positions

pelvis and hip all positions

Pelvic with both hip -
Pelvis antero-posterior both hip is a common projection used for first evaluation of pelvis bone and hip joint. The positioning of the pelvis and both hip is the same, only the centering point of the x-ray beam is different. Comparative study of both hip joints can be done in AP image and fracture in pubic ramus is also covered.

Position -
pelvis ap with both hip position The patient puts the supine on the bucky table and keeps the median Sagittal Plane coincident of the perpendicular and midline of the cassette.  

Both anterior superior iliac spine are placed at the same distance from the table so that there is no rotation in the patient

 At this time the coronal plane is parallel to the image receptor, for this we have non-opaque pad under the buttock. For this, CR cassette (35 X 43) of sufficient length is used so that the entire bony pelvis is included in the radiyograph.

The limbs are slightly abducted and rotated internally so that the neck of the femer image is parallel to the receptor.

Direction and Location of X-ray beam Collimated vertical x ray beam centers between the anterior superior iliac spine and the line joining the upper border of the symphysis pubis. The top edge of the image receptor is placed 5cm above the upper border of the iliac crest so that the entire bony pelvis is included in the radiograph due to the divergent beam.

Image characteristics

Both hip chant should appear in both hip image and upper third femora image. In Pelvis view both iliac crest, proximal femora as well as lesser trochanter image should be visible correctly. To prove that there is no rotation in the image, the dimensions of both bones should be same and both obturator foramina should be of the same shape. Shenton's line should be visible correctly. It is the curve between the inferior aspect of the femoral neck and the inferior margin of the superior pubic remi. Any type of disruption in this curve indicates femoral neck fracture.

Hip joints frog leg projection

This projection is done for comparison of both hip joint with basic antero-posterior projection. This is done in children for osterochondritis of capital epiphysis (Perthe's disease) and slipped upper femoral epiphysis (SUFE). This position is called the frog position. According to departmental protocol, gonad protection device is used.

position
frog lateral radiograph for hip joint The patient puts the supine on the bucky table and keeps the median Sagittal Plane coincident of the perpendicular and midline of the cassette. Both anterior superior iliac spine are placed at the same distance from the table so that there is no rotation in

the patient. Flex both hips and knees of the patient and rotate both limbs to lateral 60 °. In this case, both the knees are separated from each other and the planter surface of both feet comes in contact with each other. For this, CR cassette (35 X 43) of sufficient length is used so that the entire bony pelvis is included in the radiyograph. Center the image receptor at the level of the femoral pulse.

Collimated vertical x ray beam centers between the line of the femoral pulse.

Hip joint ap view

Position -
The patient puts the supine on the bucky table and puts the median Sagittal Plane perpendicular to the cassette.

Both anterior superior iliac spine are placed at the same distance from the table so that there is no rotation in the patient.

At this time the coronal plane is parallel to the image receptor, for this we have non-opaque pad under the buttock. The hip joint is detected by palpate the femoral pulse and placing it in the center of the image receptor. The limbs are slightly abducted and rotated internally so that the neck of the femer image is parallel to the receptor.

The collimated vertical x ray beam centers vertically on the femoral pulse 2.5cm away from the line joining the anterior superior iliac spine and the upper border of the symphysis pubis. The primary beam collimates on the examination area and uses gonad protection.

The image should include the proximal 1/3 part of the femer and when X-ray arthroplasty is performed to check the positioning and integrity, the prosthesis and femer should be visible in full length in the radiograph.