Hip Imaging

In general, the male pelvis is __________, with a round inlet, and the female pelvis is ___________ with a more oval inlet

In general, the male pelvis is narrower, with a round inlet, and the female pelvis is broader with a more oval inlet

What are the two standard views to view the hip and pelvis with imaging

Anteropostior view

Frog-leg view

frog-leg view

anteroposterior view

The anteroposterior view provides several advantages, as it allows viewing of

the entire pelvis, sacrum and coccyx as well as lumboscaral and femoral joints

besides providing a great full view of the pelvis the anteroposterior view also provides insight on

proximal third of shaft, femorl head and neck and angle of inclincation

Anteroposterior Patient Position The lower extremities are internally rotated ___ to ___ degrees to place the femoral neck plane parallel to the image receptor

15 to 20 degrees

The advantages of the frog leg view

Demonstrates the femoral head, neck, and proximal third of the femoral shaft and the greater and lesser trochanters from the medial aspect as well as the femoral head is exposed

disadvantages of the frog leg view

angle of inlincation of femoral neck is not visible

the posterior and anterior columns of the pelvis are represented by...

ilioischial and iliopubic lines

ilioischial line

iliopubic line

the angle of wiberg measures..

measures the extent to which the acetabulum cover the head of the femur

angle of wiberg

the angle formed must be greater than ___ degrees in an adult or dysplasia of the hip exists

25 degrees

normal angle of wiberg

25-35 degrees

DDH

shentons line

when observing shentons line, one side is..

always compaired to the other

interruption of Shenton's line can indicate

fracture neck of femur

DDH

a rapidly growing tumor may show more of a "____________" pattern like an osteosarcoma

sunburst

sunburst pattern

wards triangle

wards triangle is

Zone of weakness; area on neck of the femur where the trabeculae are weak and non-overlapping

decreased joint space bilaterally on weight-bearing surfaces may also be accompanied with...

osteophytes and increased density on the weight bearning portion of the acetabulum

The cartilage spacing at the symphysis pubis - the space should be less than __ mm wide

5 mm

Diastasis of the pubic symphysis is not uncommon following...

delivery (birth)

Calcifications in soft tissues are a result of dystrophic causes ___% to ___% of the time

95% to 98% of the time

the remaining __% to __% are the result of chondrocalcinosis, metastatic, or tumoral calcifications, and very unlikely, osteosarcoma metastases

2 to 5%

avulsion fractures of the ASIS, AIIS, ischial tuberosity, illiac wing, sacral, and ischiopubic fractures all fall into the broad category of

stable fractures

avulsion fracture of ASIS

avulsion fracture of AIIS

avulsion fracture of ischial tuberosity

iliac wing fracture

sacral fracture

ischiopubic rami fractures

vertical fractures through the body of the sacrum, L transverse sup ramus fracture w sup displacement, L comminuted inf pubic ramus fx and diastasis of the symphysis pubis are all considered

unstable fractures

Vertical fracture through the body of the sacrum

L transverse superior pubic ramus fx with superior displacement

Diastasis of the symphysis pubis

subcapital neck fracture

transcervical neck fracture

intertrochanteric fracture

subtrochanteric fracture

fracture of the greater trochanter

fracture of the lesser trochanter

some infants are born with chronically dislocating

hips

The age group at risk for chronic dislocation of the hips

2-3 years of age

chronic dislocation of the hips is found in females more frequently than males at a __ to __ ratio

4 to 1

Legg-Calvé-Perthes Disease

Avascular necrosis of the femoral head in children.

Legg-Calvé-Perthes Disease occurs more in boys than girls at a __ to __ ratio

4 to 1

The most significant defining characteristic of Legg-Calvé-Perthes Disease

flattening of the femoral head

Slipped Capital Femoral Epiphysis

seen in children during growth-spurt years. the proximal epiphysis slips from its normal position on the femoral head

Slipped Capital Femoral Epiphysis imaging

traumatic hip dislocation

Osteonecrosis

When viewing plain X-ray films for AVN, a careful review of the femoral head is required

femoral head

labral tear imaging