RAD 110 - Ch 7 Femur & Pelvic Girdle - Positioning

AP Pelvis

What projection is this?

Pelvis Routine

- AP

- Bilateral Frog-Leg

Evaluation Criteria AP Pelvis

- Rotate limbs internally (nontrauma)

- CR midway between level of ASIS and symphysis pubis

- Entire pelvis and proximal femora included

- No rotation of pelvis

- Lesser trochanters not visible

- Optimal exposure factors

AP Bilateral Frog-Leg Pelvis

What projection is this?

Evaluation Criteria AP Bilateral Frog-Leg Pelvis

- Abduct femora 40° to 45°

- CR 3 inches (7.5 cm) below level of ASIS

- 20° to 30° abduction—less distortion of femoral neck

- Pelvic girdle centered horizontally

- No rotation of pelvis

- Lesser trochanters equal in size

- Greater trochanters superimposed over femoral neck

- Optimal exposure factors

Upside Posterior Oblique Acetabulum (Judet Method)

What projection is this?

Evaluation Criteria Upside Posterior Oblique Acetabulum (Judet Method)

- CR 2 inches (5 cm) distal to upside ASIS

- Posterior rim and anterior ilioischial column demonstrated

Downside Posterior Oblique Acetabulum (Judet Method)

What projection is this?

Evaluation Criteria Downside Posterior Oblique Acetabulum (Judet Method)

- CR 2 inches (5 cm) distal and medial to downside ASIS

- Anterior rim and posterior ilioischial column demonstrated

AP Axial Outlet Pelvis (Taylor Method)

What projection is this?

Evaluation Criteria AP Axial Outlet Pelvis (Taylor Method)

- CR 20° to 35° cephalad (males), 30° to 45° cephalad (females)

- CR centered to 1-2 inches (3-5 cm) distal to symphysis pubis

- Elongated and magnified pubic and ischial bones

- No rotation of pelvis

- Pubic and ischial bones centered to collimation field

- Optimal exposure factors

AP Axial Inlet Pelvis

What projection is this?

Evaluation Criteria AP Axial Inlet Pelvis

- CR 40° caudad at level of ASIS

- Ischial spines demonstrated and equal

- Pelvic inlet centered

- Lateral collimation evident

- Optimal exposure factors

Proximal Femur/Hip Routine

- AP

- Lateral

AP Unilateral Hip

What projection is this?

Evaluation Criteria AP Unilateral Hip

- CR perpendicular to midfemoral neck

- Proximal ⅓ of femur included

- Hip joint space and acetabulum visualized

- Lesser trochanter not visible or only slightly visible

- Total existing orthopedic prosthesis demonstrated

- Optimal exposure factors

Unilateral Frog-Leg Hip (Modified Cleaves Method)

What projection is this?

Evaluation Criteria Unilateral Frog-Leg Hip (Modified Cleaves Method)

- Abduct femur 45° from vertical (for best demonstration of femoral head and acetabulum, abduct femur to 90° from vertical)

- CR perpendicular to midfemoral neck

- Entire femoral head, neck, and trochanters centered to IR

- Femoral head and neck in profile

- 45° abduction (20° to 30° abduction—less distortion of femoral neck)

Axiolateral Inferosuperior Hip (Danelius-Miller Method)

What projection is this?

Evaluation Criteria Axiolateral Inferosuperior Hip (Danelius-Miller Method)

- CR perpendicular to midfemoral neck

- Entire femoral head, neck, and acetabulum visualized

- No visible grid lines

- Optimal exposure factors

- Compensating filter recommended

Modified Axiolateral Hip (Clements-Nakayama Method)

What projection is this?

Evaluation Criteria Modified Axiolateral Hip (Clements-Nakayama Method)

- CR 30° to 40° mediolateral and 15° to 20° posteriorly from horizontal

- CR centered to femoral neck

- Entire femoral head, neck, and trochanters centered to IR

- Femoral head and neck in profile

Lateral (Mid & Proximal) Femur/Hip

What projection is this?

Evaluation Criteria Lateral (Mid & Proximal) Femur/Hip

- Proximal femur not superimposed

- True lateral

Mid & Distal Femur Routine

- AP

- Lateral

AP (Mid and Distal) Femur

What projection is this?

Evaluation Criteria AP (Mid and Distal) Femur

- Rotate leg 5° internally

- CR to midpoint of IR

- Knee joint included

- No rotation

- From knee joint up as high as you can get on IR.

Lateral (Mid and Distal) Femur

What projection is this?

Evaluation Criteria Lateral (Mid and Distal) Femur

- True lateral

- Mediolateral

- CR to midpoint of IR

- Knee joint included (minimum)

- No rotation, knee will appear tilted, this is normal. That's why we angle on a lateral knee.

- Include knee joint up as high as will fit on the IR.

Trauma Lateral (Mid and Distal) Femur

What projection is this?