Judet Views of the Pelvis Notes

Judet Views

Judet views are 45-degree obliques of the pelvis used to visualize the acetabular rim and surrounding areas. They focus on:

  • Acetabular rim (both posterior and anterior aspects)
  • Anterior and posterior columns

Clinical indication: Post-trauma, suspected acetabular fracture.

Anatomy Reminder: Rims and Columns

  • Anterior Column: Front part of the acetabulum.
  • Posterior Column: Back part of the acetabulum.
  • Anterior Rim: Solid line representation.
  • Posterior Rim: Dotted line representation.

Detecting Rotation

A helpful side note on detecting rotation:

  • Left ischial spine is not superimposed over the pelvic brim.
  • Sacrum and coccyx rotated to right hip
  • Left obturator foramen is narrowed
  • The patient is in an LPO
  • Correction: rotate the patient towards the right hand side (raise left side)

Acetabulum Visualization

When supine, the anterior column is superimposed on the posterior column, with the posterior column seen more laterally, overlying the head of the femur. The acetabulum sits on an oblique plane facing anteriorly.

  • Raised right hip: The anterior column is demonstrated medially (clearly demonstrated along with the obturator foramen), and the posterior rim is brought forward and more clearly seen.
  • Lowered right hip: The posterior column is projected medially (note the ischial spine is seen in profile), and the anterior rim is demonstrated in this view.

Positioning

Anterior Rim (Iliac Oblique View)

  • Used to assess the anterior rim and posterior column.
  • Patient lies supine with both legs extended.
  • Raise the unaffected side 45 degrees and support with foam pads.
  • CR (Central Ray): Vertical
  • CP (Central Point): On the acetabulum or midway between the ASIS (Anterior Superior Iliac Spine) and symphysis pubis.

Posterior Rim (Obturator Oblique View)

  • Demonstrates the posterior rim and anterior column.
  • Patient lies supine with both legs extended.
  • Raise the affected side 45 degrees and support with foam pads.
  • CR: Vertical
  • CP: To the raised acetabulum, about 5 cm lateral to the raised ASIS.

Image Criteria

  • The acetabulum should be well demonstrated and near the center of the image.
  • The head and neck of the femur should be included.