Unit 3: Pelvis, Hip, SI Joints, Femur

Our _________ serves as a base for our trunk and a girdle for the attachment of our lower limbs.

pelvis

The pelvis contains what four bones:

two hip bones (innominate bones), and the sacrum, and coccyx

The pelvis is divided into 2 portions by a boundary line called the brim of the pelvis. Above the brim is called the:

False (greater) pelvis

The pelvis is divided into 2 portions by a boundary line called the brim of the pelvis. Below the brim is called the:

True (lesser) pelvis

The female pelvis is shaped for childbearing and delivery so it is ___________ compare to the male pelvis.

wider & shallower

T/F: The female pelvis’s inlet is larger and more oval or rounded shaped.

True

For an AP Pelvis, medially rotate both feet ________ degrees.

15-20

For an AP Pelvis, the CR should be centered to:

midway between ASIS and pubic symphysis (this is about 2” inferior to ASIS)

For an AP Pelvis Bilateral Frog-Leg "Modified Cleaves" the CR should be centered:

1-inch superior to the pubic symphysis (3 inches below ASIS)

For an AP Outlet view, the CR angle should be __________ degree for a male and _________ degree for a female.

Males: Angle 20-35 cephalad Females: Angle 30-45 cephalad

For an AP Outlet view, the CR should be centered to:

1-2 inches distal to the upper border of the pubic symphysis

For an AP Inlet view, the CR should be ______ degrees _______.

40 degrees caudal

For an AP Inlet view, the CR should enter at the:

midline at level of ASIS

For an AP Oblique Pelvis (Acetabulum): Judet Method: LPO & RPO, the patient should be positioned __________ degrees oblique.

45

In the Judet view, the posterior oblique position (LPO and RPO) demonstrates the __________ (downside/upside) acetabulum and more specifically the __________ (anterior/posterior) rim of the acetabulum.

downside, anterior (ants go down in the ground)

In the Judet view, the anterior oblique position (LAO and RAO) demonstrates the __________ (downside/upside) acetabulum and more specifically the __________ (anterior/posterior) rim of the acetabulum.

upside, posterior (posts go up)

If the anterior acetabulum is of interest in the Judet view, the CR should be directed:

2 inches distal and 2 inches medial to downside ASIS (ants go marching 2 by 2)

If the posterior acetabulum is of interest in the Judet view, the CR should be directed:

2 inches distal to upside ASIS

The hip bone consists of what 3 bones:

Ilium, pubis, ischium (they are fused together to make up the acetabulum )

The acetabulum fuses during the middle _________ years.

teenage

The Hip joint is a ____________ type of joint.

Synovial (synovial fluid), Diarthrodial (freely moveable), Ball and socket

T/F: The obturator foramen is the largest foramen in the skeletal system.

True

The pubic symphysis joint is classified as:

Cartilaginous joint, Amphiarthrodial (limited movement)

SI Joints is classified as a:

Synovial joint Amphiarhtrodial (little movement)

SI Joints go at a __________ degree angle from MSP.

25-30

For a unilateral AP hip, the CR should be centered:

CR 1-2 medial & 3-4 inches distal to ASIS

For a unilateral AP hip, the leg should be rotated internally ___________ degrees.

15-20

The femoral neck can be found by going ______ inches medial to the ASIS and ______ inches distal.

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

In a unilateral Frog Leg radiograph, you should be able to visualize:

the acetabulum, femoral head, and the femoral neck

For a x-table lateral hip (Danelius-Miller Method), the IR should be __________ (parallel/perpendicular) to the femoral neck, and the CR should be _________ (paralle/perpendicular) to the femoral neck and IR.

parallel, perpendicular

For a Clements-Nakayama view, the grid is tilted ______ degrees from vertical and parallel with the femoral neck, and you should angle the CR mediolaterally, _______ degrees from horizontal and centered to femoral neck.

15, 15

When a patient has bilateral hip fractures or limitation of movement of the unaffected leg, the ______________ can be used to obtain a lateral view.

Clements-Nakayama

The Female sacrum/coccyx curve more ____________ (anteriorly/posteriorly) than males.

posteriorly

For AP Axial SI Joints, the CR should be centered:

2 inches below ASIS

For AP Axial SI Joints, a _______ degrees cephalad for males _______ degrees cephalad for females.

30 degrees cephalad for males, 35 degrees cephalad for females

For a posterior oblique SI joint (LPO or RPO), we are looking at the _____________ (upside/downside) SI joint.

upside

For a posterior oblique SI joint (LPO or RPO), we should elevate side of interest ___________ degrees.

25-30

For a posterior oblique SI joint (LPO or RPO), the CR should enter:

1-inch medial to upside ASIS

For a anterior oblique SI joint (LAO or RAO), we are looking at the __________ (upside/downside) SI joint.

downside, “eyes down, side down”

For a anterior oblique SI joint (LAO or RAO), we should rotate the side of interest to table _________ degrees.

25-30

For a anterior oblique SI joint (LAO or RAO), the CR should enter:

1-inch medial to the ASIS closest to the IR

The proximal femur consists of what four essential parts:

the head, neck, the greater and the lesser trochanters

For an AP femur Mid/Proximal, we should rotate the femur ____________ degrees medially.

15-20

if we are doing a dedicated distal AP femur, we should rotate the leg internally about _________ degrees to open the knee joint more.

5

Pathology - describe Ankylosis:

Calcification of anterior longitudinal ligament, fusion of the spine and SI joints, bamboo spine appearance (from bony outgrowths), males most affected

Pathology - describe Legg-Calve-Perthes Disease:

Limp is the first clinical sign, aseptic/ ischemic necrosis, flattened shape of the head of the femur, most common: 5-10 year old boys

Pathology - describe Chondrosarcoma:

Malignant tumor of cartilage, found in Pelvis and long bones. Treatment includes surgery, radiation/chemotherapy. Most common: Men older than 45 years

Lytic lesions are _____________ (radiopaque/radiolucent).

radiolucent

Sclerotic lesions are ___________ (radiopaque/radiolucent).

radiopaque

Pelvic ring fractures usually occur from:

High-force trauma (motorcycle accidents or a fall from 20 or more feet)

T/F: Pelvic ring fractures usually have a matching fracture at the opposite point.

True

Pathology - describe Avulsion Fracture:

Small pieces of bone are broken from its insertion point. It is from a sudden force of tendon or ligament being pulled forcefully

Tendons attach:

muscle to bone

Ligaments attach:

bone to bone