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Pelvic Girdle

Pelvic Girdle. 1 st year 1 st quarter. HIP. *AP affected hip **If this is the initial exam of the hip you might need to take a AP pelvis instead of a AP hip *Lateral affected hip. Structures shown AP Hip.

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Pelvic Girdle

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  1. Pelvic Girdle 1st year 1st quarter

  2. HIP *AP affected hip **If this is the initial exam of the hip you might need to take a AP pelvis instead of a AP hip *Lateral affected hip

  3. Structures shownAP Hip • Head, neck, trochanters and proximal one third of the body of the femur. *The pubic symphysis must be shown on one view of the hip

  4. Good Film • Lower portion of the ilium and pubic symphysis should be included on the film. • Any orthopedic appliance should be included in its entirety • The greater trochanter should be in profile • The long axis of the femoral neck should be seen • The proximal third of the femur should be included • Little or none of the lesser trochanter should be visible beyond the medial edge of the femur

  5. AP Right Hip pubic symphysis Neck greater trochanter Lesser trochanter

  6. Bursitis AP Right Hip

  7. AP left Hip

  8. Bone graft

  9. OUCH!

  10. Structures shownLateral hip(mediolateral Lauenstein method) • A lateral projection of the hip is demonstrated, showing the acetabulum, the proximal end of the femur, and the relationship of the femoral head to the acetabulum

  11. Good Film • ***Don’t do this view if fracture is likely or patient is post-op for less than three days. • The hip joint should be centered to the film. • The hip joint, acetabulum, and femoral head should be well demonstrated.

  12. Hip pinning Lateral Right Hip

  13. Lateral Right Hip End of hardware Plug

  14. Lateral Right Hip Extra bone formation after surgery

  15. Lateral Left Hip

  16. Lateral Right Hip

  17. Pediatric Patients: Congenital Hip Abnormalities • AP pelvis • Modified Cleaves (***not done if fracture is suspected)

  18. Diaper

  19. “Frog legs” Modified Cleaves method For pediatric patients with congenital hip abnormalities

  20. Structures shownAxiolateral Hip (Danelius-Miller) • Axiolateral projection of the acetabulum and the proximal femur to include the head, neck, and trochanters. *** This view is done to see the neck

  21. Good Film: • Do this view if fracture is likely or patient is post-op. • As much of the femoral neck should be seen as possible without overlap from the greater trochanter • Only a small amount of the lesser trochanter should be seen on the posterior surface of the femur • A small amount of the greater trochanter should be seen on the anterior and the posterior surfaces of the proximal femur (when it is safe for the femur to be inverted) • The soft tissue shadow of the unaffected thigh should not overlap the hip joint or proximal femur. • The hip joint with the acetabulum should be included .

  22. Soft tissue Other leg neck Greater trochanter X-Table Lateral Lt Hip

  23. RT Don’ forget you might have to build your Pt up ! X-Table Lateral Rt Hip

  24. Other leg in the way! X-Table Lateral Rt hip

  25. Judet’s method • RPO • LPO Structures shown: The acetabular rim

  26. Different than Merrill’s: • We want AP oblique position to include both hips on each film.(always do both obliques) The whole pelvis should be included. The iliac wing is also well visualized.

  27. Why would you do them? • Used to demonstrate fractures of the posterior (ilioischial) column and anterior rim of the acetabulum.

  28. Rt Hip Down: RPO L

  29. Left Hip Down :LPO

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