Chapter 7

Hip and Pelvis

Pelvis

• Connects lower extremities to the axial skeleton

• Consists of – ____________– 1 sacrum – ____________

• _____________– 2 hip bones only

Hip Bones

• _________

• Ischium

• ________

• ____________ – The area of fusion for the 3 bones.

Ilium

• _______–Large winged area

• Body– Inferior to the Ala. Includes superior

acetabulum • ____________• _______, AIIS, PSIS, PIIS.

Ischium

• Inferioposterior to acetabulum.

• ___________– Posterior acetabulum to ischial tuberosity

• __________– Anterior portion off of ischial tuberosity

Ischium

• Ischial ____________– Rounded, rough area at the border of lower

body and Ramus• Ischial ____________

– Posterior bony protrusion off acetabulum• Greater/Lesser _____________

– Depression superior and inferior to ischial spine

Pubis

• Anterioinferior to acetabulum.• ________

– Anteriorinferior acetabululum to superior ramus • Superior __________

– Anterior medial extensions meeting to form symphysis pubis.

• Inferior ___________– Inferioposterior extension off symphysis pubis to

Ischial Ramus• _______________

– Hole formed by ischium and pubis

True and False Pelvis

• ___________– Area surrounded by bone– _______to pelvic brim– Birth Canal– Inlet and Outlet

• ____________– Area formed by Alae– ______ to pelvic brim

Male vs. Female Pelvis

• Male– Narrower– Deeper– ___________– ______pubic arch– Narrow inlet– ______Obturator Foramen

• Female– Wider– ___________– ______pubic arch– Larger inlet– _______ Obturator Foramen

Joints of the Pelvis

• Sacroiliac Joint ________– Amphiarthrodial synovial, sacrum to pelvis

• ____________ Pubis – Amphiarthrodial cartilaginous. Rt and Lt pubic

bones• Union of Acetabulum

– Synarthrodial cartilaginous. 3 fused hip bones• _____________

– Diarthrodial synovial spheroid.

Imaging the Pelvis

Routine• AP• 14 x 17 XW• 40” SID• 75 kV

AP Pelvis

• Pt __________• Internally rotate legs ___________• Center Midline between _______ and

__________Pubis• Top of Cassette ____________Crest• Collimate to skin• If Trauma do not rotate legs *****

Proximal Femur

• __________– Round process

• ___________– Depression in the center of the head

• Neck – Area between shaft and head

• Acetabulum– Cavity for head of femur

Proximal Femur

• Greater _______________– Superiolateral prominence

• Lesser _______________– Medioposterior prominence inferior to greater

trochanter.• Intertrochanteric Crest

– Depression between trochanters

Femur Angle

• Not ________

• Angle of positioning importance– Head and neck = ___________angle.

• Rotate legs Internally (Pigeon Toe) to get ______________

Fracture Sign

• Look at the _________– For symmetry

• If one is _________ and one is _______rotated, possible fracture.

Hip Imaging

Routine• AP Pelvis• AP Unilateral Hip• Lateral

– Frog Leg– X-table lateral

• 40” SID• 75 kV

AP Hip

• Patient Supine• Rotate Leg ____________• CR directed __________to femoral neck• ___medial and ___ distal to _______

Frog leg Lateral

• Pt Supine• Flex knee and externally ____________• A sponge may help• Center to Femoral Neck

– Draw ___________between ASIS and Symphysis Pubis and _________ perpendicular to line

X-table Hip

• Pt Supine• Do not move __________• Unaffected Leg ______________. Can put

leg on collimator• Use _____________grid parallel to

femoral neck• Adjust collimator to be __________ to

cassette.

Sacroiliac Joint Imaging

• Place patient into ____________ Posterior Oblique

• The joint of interest is _________– ______ for left SI joint

• Direct CR ____ medial to upside ASIS