Femur and Pelvic Girdle

femur

• longest and strongest bone in the body

• body weight is transferred by this bone therefore, it is related to frequent trauma

proximal femur includes

• head

• neck

• greater trochanter

• lesser trochanter

head of femur

• rounded and smooth for articulations with the hip bones

• fovea capitis is a depression or pit for the ligament of the femur is attached to the head

neck of femur

• strong pyramidal process that connects the head and body to the trochanters

• common site for fractures

greater trochanter

• larger prominence superior and lateral to the femoral shaft

• palpable

lesser trochanter

small, blunt eminence medial and posterior from the junction of the neck and shaft

rotation from the greater trochanter

internal rotation

rotation for the lesser trochanter

external rotation

xray for greater trochanter

AP

xray for lesser trochanter

cleaves/frog leg

angle of the femoral neck to the shaft

125 degrees ± 15 degrees based on width of pelvis

longitudinal plane of the femur

10 degrees from vertical

why do we need to rotate the legs 15-20 degrees internally

anterior angle of the head and neck in reference to the body is 15-20 degrees

means basin

pelvis

pelvis

• serves as trunk

  • connecting point for vertebrae and lower extremities

hip consists of four bones

2 hip bones (ossa coxae and innominate bones), sacrum, coccyx

false pelvis

bony part

true pelvis

empty part

pelvic girdle only consists of the

2 hip bones

the hip bones

separate until teenage years

fusion starts at the

acetabulum that meets with the femoral head to form the hip

ilium

• largest of the three hip bone divisions

• superior to acetabulum

• ala and body

• inferior and upper 2/3 of the acetabulum

Other name for the ala

wing

ASIS

palpable landmark for many radiographs

Ischium

• inferior and posterior to acetabulum

• posteroinferior 2/5ths of the acetabulum

divided into a body and ramus, projects anteriorly from ischial tuberosity

ischium

ischial spine

is a bony projection posterior to the acetabulum

bears most of the weight when a person sits

ischium

pubis

• anterior and inferior to acetabulum

• anteroinferior 1/5 of the acetabulum

2 superior ramus meet at the

symphysis pubis

obturator foramen

large opening created by the ramus and body of each ischium and the pubis

ASIS as a landmark

• checks for rotation of the pelvis

• equal distance from ASIS and table

greater trochanter

• soft tissues of the upper thigh

• same level as symphysis pubis

symphysis pubis and greater trochanter

4’’ distal from ASIS

ischial tuberosity

1.5 - 2’’ below symphysis pubis

male pelvis

• narrow and deeper

• acute angle of less than 90 degrees

• oval or heart shaped inlet

female pelvis

• wider and flared

• shallow from front to back

• obtuse angle is more than 90 degrees

• round and larger inlet

sacroiliac joint

synovial and amphiarthroidal

symphysis pubis

cartilaginous and amphiarthroidal

union of acetabulum

cartilaginous and synarthroidal

hip joint

synovial, diarthroidal, and ball and socket

location of femoral neck

1-2’’ medial and 3-4’’ distal from ASIS

hip fractures appear as

external rotation of the foot

external rotation of leg

lateral

internal rotation of leg

AP

for pediatric hips

ultrasound is best

geriatrics

most hip/pelvis PTs

CT is best used to view

the relationship of the femoral head to acetabulum

MRI is best used for 

soft tissue injury or joint abnormality

ultrasound is best used for

newborns and hip dislocations, 4-6 m.o.

if a PT fell 3 months ago and is now coming in with hip pain it is

non-trauma

patient fell 5 minutes ago, was brought in by ambulance, one leg turned out

trauma

PT has pain on the left side after falling on the left side

hip x-ray

PT fell on back and now side hurts

pelvis x-ray