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Comprehensive Overview of the Hip and Pelvis Anatomy and Imaging Techniques

This chapter presents a detailed exploration of the hip and pelvis anatomy, including the connections of the lower extremities to the axial skeleton. It describes the key bone structures—sacrum, ilium, ischium, and pubis—along with their features and relationships. Also covered are the distinctions between male and female pelvises, including their dimensions and shapes. Additionally, the chapter discusses the various joints of the pelvis, including their types and imaging techniques, emphasizing protocols for pelvic X-rays and hip imaging, including patient positioning and necessary angles for optimal results.

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Comprehensive Overview of the Hip and Pelvis Anatomy and Imaging Techniques

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  1. Chapter 7 Hip and Pelvis

  2. Pelvis • Connects lower extremities to the axial skeleton • Consists of • ____________ • 1 sacrum • ____________ • _____________ – 2 hip bones only

  3. Hip Bones • _________ • Ischium • ________ • ____________ – The area of fusion for the 3 bones.

  4. Ilium • _______ • Large winged area • Body • Inferior to the Ala. Includes superior acetabulum • ____________ • _______, AIIS, PSIS, PIIS.

  5. Ischium • Inferioposterior to acetabulum. • ___________ – Posterior acetabulum to ischial tuberosity • __________ – Anterior portion off of ischial tuberosity

  6. Ischium • Ischial____________ • Rounded, rough area at the border of lower body and Ramus • Ischial____________ – Posterior bony protrusion off acetabulum • Greater/Lesser _____________ – Depression superior and inferior to ischial spine

  7. Pubis • Anterioinferior to acetabulum. • ________ • Anteriorinferioracetabululum to superior ramus • Superior __________ – Anterior medial extensions meeting to form symphysis pubis. • Inferior ___________ – Inferioposterior extension off symphysis pubis to Ischial Ramus • _______________ – Hole formed by ischium and pubis

  8. ___________ Area surrounded by bone _______to pelvic brim Birth Canal Inlet and Outlet ____________ Area formed by Alae ______ to pelvic brim True and False Pelvis

  9. Male Narrower Deeper ___________ ______pubic arch Narrow inlet ______ObturatorForamen Female Wider ___________ ______pubic arch Larger inlet _______ Obturator Foramen Male vs. Female Pelvis

  10. Joints of the Pelvis • Sacroiliac Joint ________ – Amphiarthrodialsynovial, sacrum to pelvis • ____________ Pubis – Amphiarthrodial cartilaginous. Rt and Lt pubic bones • Union of Acetabulum – Synarthrodial cartilaginous. 3 fused hip bones • _____________ – Diarthrodialsynovial spheroid.

  11. Imaging the Pelvis Routine • AP • 14 x 17 XW • 40” SID • 75 kV

  12. AP Pelvis • Pt__________ • Internally rotate legs ___________ • Center Midline between _______ and __________Pubis • Top of Cassette ____________Crest • Collimate to skin • If Trauma do not rotate legs *****

  13. Proximal Femur • __________ – Round process • ___________ – Depression in the center of the head • Neck – Area between shaft and head • Acetabulum • Cavity for head of femur

  14. Proximal Femur • Greater _______________ – Superiolateral prominence • Lesser _______________ – Medioposterior prominence inferior to greater trochanter. • Intertrochanteric Crest – Depression between trochanters

  15. Femur Angle • Not ________ • Angle of positioning importance • Head and neck = ___________angle. • Rotate legs Internally (Pigeon Toe) to get ______________

  16. Fracture Sign • Look at the _________ • For symmetry • If one is _________ and one is _______rotated, possible fracture.

  17. Hip Imaging Routine • AP Pelvis • AP Unilateral Hip • Lateral • Frog Leg • X-table lateral • 40” SID • 75 kV

  18. AP Hip • Patient Supine • Rotate Leg ____________ • CR directed __________to femoral neck • ___medial and ___ distal to _______

  19. Frog leg Lateral • Pt Supine • Flex knee and externally ____________ • A sponge may help • Center to Femoral Neck • Draw ___________between ASIS and Symphysis Pubis and _________ perpendicular to line

  20. X-table Hip • Pt Supine • Do not move __________ • Unaffected Leg ______________. Can put leg on collimator • Use _____________grid parallel to femoral neck • Adjust collimator to be __________ to cassette.

  21. Sacroiliac Joint Imaging • Place patient into ____________Posterior Oblique • The joint of interest is _________ • ______ for left SI joint • Direct CR ____ medial to upside ASIS

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