4/18/2024 0 Comments Normal female adult right hip xray![]() ![]() Interpretation of Plain Radiographic Images The crosshairs of the beam should be directed at a point midway between the anterior superior iliac spine (ASIS) and the pubic symphysis, and the tube-to-film distance should be approximately 40 inches in a line directed perpendicular to the table. Each leg should be abducted 15 to 20 degrees from the midline, and the pelvis and tibia should be parallel to the long axis of the body (neutral rotation). For both views, the film cassette is placed beneath the pelvis and the tube is centered over the upper border of the pubic symphysis. The 90-degree Dunn view assesses the patient with 90-degree hip flexion, whereas the 45-degree Dunn view (“modified Dunn view”) assesses the patient with 45 degrees of hip flexion ( Fig. It was originally described as a technique to measure femoral neck anteversion in children. The Dunn view is commonly used for assessment of femoral head sphericity in patients believed to have cam-type femoroacetabular impingement (FAI). (From Clohisy JC, Carlisle JC, Beaulé PE, et al: A systematic approach to the plain radiographic evaluation of the young adult hip. The standing AP radiograph assesses (1) functional leg length inequalities (2) neck shaft angle (NSA) (3) femoral neck trabecular patterns (4) lateral and anterior center edge angles (5) acetabular inclination (6) joint space width (7) lateralization (8) head sphericity (9) acetabular cup depth and (10) anterior and posterior wall orientation ( Figs. A standing rather than a supine AP radiograph is obtained because acetabular roof obliquity, center edge angle, and minimum joint space width may vary between weight-bearing and supine positions. A 1- to 3-cm gap should be seen between the apex of the coccyx and the superior border of the pubic symphysis for proper pelvic inclination. ![]() The radiographic teardrops, iliac wings, and obturator foramina should be symmetrical in appearance. The coccyx should be centered in line with the pubic symphysis. The crosshairs of the beam should be centered on a point half the distance between the superior border of the pubic symphysis and on a line drawn connecting the anterior superior iliac spine. Both lower extremities should be internally rotated by 15 degrees to account for normal anatomic anteversion, and this position helps maximize the view of the femoral neck. The x-ray tube–to-film distance should be approximately 120 cm, and the x-ray tube should be aimed perpendicular to the film. Descriptions of each view are provided in the following sections.Ī proper AP view should be taken with the patient standing. All views are technique dependent, and each demonstrates a different anatomic perspective of the hip joint. Among these, the most commonly referenced include the AP view of the pelvis (AP pelvic view), a cross-table lateral view, a 45-degree or 90-degree Dunn view, a frog-leg lateral view, and a false-profile view. Several radiographic views are important for proper evaluation of the hip. Traditionally, the lateral hip radiograph demonstrates details of the femoral neck and helps identify cam impingement pathology, whereas the anteroposterior (AP) view demonstrates the acetabular version. This chapter describes the key imaging studies used when examining a skeletally mature patient with a pathologic hip, as well as a systematic approach to interpretation of these studies. Although the history and physical examination play a critical role in determining the diagnosis, it is also important to have a systematic approach to help diagnose these disorders radiographically. It is almost exclusively used in the pediatric population to assess for slipped upper femoral epiphysis (SUFE) and Perthes disease.A multitude of structural hip disorders can occur in athletes with hip pain. bilateral examination allows for better visualization of the hip joints and femoral neck.lataral projection to aid and diagnose femoroacetabular impingement (FAI) due to its increased sensitivity for detecting femoral head-neck asphericity.the ideal projection for bilateral hip or femur trauma.lateral projection demonstrating the neck of the femur without movement of the either limb.can only be conducted on unilateral hip trauma.lateral projection demonstrating the neck of the femur without movement of the affected limb.standard rolled lateral view demonstrating the femoral neck and acetabular rim can only be performed on non-trauma patients.often only performed in follow up studies.demonstrates the hip joint in the AP plane, with the limb internally rotated so the neck of the femur is in profile.Hip radiographs are performed for a variety of indications including 1-3: The series is requested for a myriad of reasons from trauma to atraumatic hip pain. The hip series is comprised of an anteroposterior (AP) and lateral radiograph of the hip joint. ![]()
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