Hip/Pelvis Exam

Developmental Dysplasia of the Hip (Congenital Hip Dysplasia)

Incomplete acetabulum formation

Developmental Dysplasia of the Hip

Legg-Calvé-Perthes Disease

Interruption in blood supply to femoral head (ischemic necrosis)

Legg-Calvé-Perthes Disease

Slipped Capital Femoral Epiphysis (SCFE)

Femoral head slides posteriorly off the neck

Slipped Capital Femoral Epiphysis (SCFE)

Hip Dislocation

The displacement of femoral head from acetabulum

Hip Dislocation

Proximal Femur Fracture

A break in the proximal femur bone affecting hip joint stability

Proximal femur fracture

Avulsion Fractures

Bony fragments torn from the pelvis 

Avulsion fracture

Pelvic Ring Fractures

Any traumatic disruption of the pelvic ring anteriorly and posteriorly in two or more places

Open Book Pelvic Fracture

Common pelvic ring fracture caused by anterior compression force of the pelvis, causing diastasis of the symphysis pubis of more than 5 mm

Open book fracture

Acetabulum Fracture

Fracture of the acetabulum

Acetabulum fracture

Red?

Hip bones

Yellow?

Sacrum

Blue?

Coccyx

What is the purpose of the pelvis?

Serves as base for trunk of body, acts as a girdle to attach to legs

What are the bones of the pelvis?

2 hip bones, sacrum and coccyx

What are other names for hip bones?

Os coxae and innominate bones

What are the 3 distinct bones of the hip?

Ilium, pubis and ischium

The 3 bones of the hip fuse together to form the…?

Acetabulum

Red?

Ilium

Yellow?

Pubis

Green?

Ischium

What does the Ilium consist of?

Body and ala

What does the ischium consist of?

Body and ischial ramus

What does the pubis consist of?

Body, superior and inferior ramus

1?

Posterior superior iliac spine

2?

Posterior inferior iliac spine

3?

Greater sciatic notch

4?

Ilium

5?

Iliac crest

6?

Anterior superior iliac spine

7?

Anterior inferior iliac spine

1?

Ischial body

2?

Ischial spine

3?

Ischial tuberosity

4?

Ischium

5?

Ischial ramus

1?

Superior ramus

2?

Pubic tubercle

3?

Body of pubis

4?

Inferior ramus

What is the angle of the longitudinal plane of the femur?

10 degrees

What is the angle of the neck of the femur from the midline of the body?

45 degrees

What is the angle of the neck of the femur?

120-130 degrees

How far anteriorly does the femoral neck project from the femur?

15-20 degrees

Pelvis Inlet (Brim)

Also known as the superior aperture; extends from sacral promontory to top margin pubic symphysis 

Pelvis inlet (brim)

Pelvic Outlet

Also known as inferior aperture; measured from the tip of the coccyx to the inferior margin of the pubic symphysis 

Pelvic outlet

Green?

Greater (false) pelvis

Yellow?

Lesser (true) pelvis

What is the joint classification of sacroiliac joint and hip joint?

Synovial

What is the joint classification of symphysis pubis?

Cartilaginous

Female Pelvis

Wide shape, oval inlet, sacrum is wider and curves more sharply/posteriorly, obtuse pubic arch

Male Pelvis

Narrow shape, round inlet, acute pubic arch

A?

Obturator foramen

B?

Pubic symphysis

C?

Ala (wing) of ilium

D?

Greater trochanter

E?

Lesser trochanter

F?

ASIS

A?

Femoral neck

B?

Ischium

C?

Superior rami of pubis

D?

Inferior rami of pubis

A?

Acetabulum

B?

Femoral head

C?

Femoral neck

D?

Greater trochanter

E?

Lesser trochanter

AP and lateral hip technique

85 kVp, center cell (10 mAs)

AP and lateral hip collimation

10×12 A

AP and lateral hip breathing

Suspended respiration

For an AP hip, how much do you medially rotate the leg?

15-20 degrees

Cross-table lateral hip technique

90 kVp, center cell (32 mAs)

Cross-table lateral hip collimation

12×10