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DRMG2104IMAGE EVALUATION 1
LECTURE 6PELVIC GIRDLE
MOHD IMRAN BIN MOHDBachelor of Diagnostic Imaging & Radiotherapy ( UKM )
RADIOGRAPH EVALUATION
P-PROJECTION/POSITION A-AREA C-COLLIMATION & CR E-EXPOSURE M-MARKER A-ALIGNMENT N-NAME(ID)
SUB TOPIC
HIP PELVIS SI Joint
PELVIS (AP)
PELVIS (AP) Projection/position:-
True AP- ischial spine aligned-pelvic brim Sacrum-coccyx aligned-symphysis pubis Ilia & obturator foramen uniform in size and shape
Leg positioning (15-20° internally) Femoral neck not foreshortened Greater trochanter in profile laterally Lesser trochanter superimposed with femoral
neck
Projection/position AP Hip Rotation detection :-
ischial spine not superimposed with pelvic brim
Sacrum/coccyx not aligned with symphysis pubis
-rotated away from side of rotation Ilium wider on side of rotation Obturator foramen narrower on side of
rotation
AREA : pelvis SIJ , hip joint & symphysis pubis ( sp ) upper femur L5 and L4 Recognized the shielding area ( male /
female ) if necessary.
FEMALE PELVIS-GONAD SHIELD
MALE PELVIS-GONAD SHIELD
FEMALE PELVIS
MALE PELVIS
Collimation : Upper border include : iliac crest Lower border included : ischial tuberosity & upper
femur Lateral border : both rt & lt greater trochanters
Exposure : 75 – 85 kVp , 15 - 25 mAs Penetration : bony trabecular patterns & corticle
outlines of ischial spine, pubis, femoral head, ala Contrast & density : soft tissue & bony structures
seen.
AP PELVIS ( frog leg )position
AP PELVIS ( frog leg )position
Pelvis in true APFemoral positioning:- Knee flexfemur 60-70° from table top
Lesser trochanter demonstrated in profile medially
Femoral neck superimpose the greater trochanter
Femoral abduction 45° from table topFemoral neck partially superimposedGreater trochanter at a transverse level
halfway between femoral head & lesser Tr.
AP PELVIS ( frog leg )position
Effect of Distal Femur elevation Knee not flexed enough:-
Greater trochanter demonstrated laterally Knee flexed too much:-
Greater trochanter demonstrated mediallyEffect of leg abduction: Close to table top:-
Femoral shaft not foreshortened,femoral neck “on-end” 45° to table top
Femoral neck and femoral shaft partially foreshortened 70°to table top:
Femoral neck not foreshortened femoral shaft foreshotened
AP PELVIS ( frog leg )position
HIP (AP)
True AP:- Ischial spine is aligned with pelvic brimSacrum & coccyx aligned with symphysis
pubisObturator foramen is open
Femur positioning:-Leg 15-20° rotate internally:-Femoral neck without foreshortenedGreater trochanter in profile laterallyLesser trochanter superimposed by femoral
neck
HIP (AP)
HIP (AP) Femoral head
Acetabulum
Fovea capitis
Greater trochanter
Lesser trochanter
Femoral neck
Intertrochentric line/crest
Obturator foramen
Male & Female Hip
Femoral neck angulation for male greater than female
HIP ( AXIOLATERAL)@ Inferosuperior Projection
Position/projection:-Femoral neck without foreshortenedLesser & greater trochanter are demonstrated at
about same transverse level. Leg positioning(15-20 °internal rotation):
Lesser trochanter demonstrated in profile posteriorly
Greater trochanter superimposed by femoral neck
HIP ( AXIOLATERAL)@ Inferosuperior Projection
Femoral neck at the center of collimated field
Acetabulum, femoral head & neck, greater & trochanters, ischial tuberosity included in collimated field.
Any orthopedic appliance should be included
HIP ( AXIOLATERAL)@ Inferosuperior Projection
HIP (Rolled Lateral)
Position/projectionRolled to the affected sideLesser trochanter in profile mediallyGreater trochanter superimposed with femoral
neck Ischial spine in profileObturator foramen narrowed
HIP (Rolled Lateral)
•Proximal femur
• femoral head
• ischial spine
• obturator foramen
• half ilium
• SI joint in
SI JOINT (AP)
SI JOINT (AP) Projection/position True AP:-
Median sacral crest aligned with symphysis pubis
Sacrum equal distance from lateral wall of the pelvic brim on either side
Correct CR(25-30 cephalic)-SI joint not foreshortenedSacrum elongatedSymphysis pubis superimposing
inferior sacral segment.
SI JOINT (AP)
Sufficient contrast & density to show bony structures and soft tissue of SI joint
Sufficient penetrationbtb & cto of SI joint and 1st -3rd sacral segments
Second sacral segment @ the center of collimated field
Long axis of median sacral crest is aligned with long axis of collimated field
SI JOINT (AP)
SI JOINT (POSTERIOR OBLIQUE)
Position/projectionSI joint is open (unaffected side midcoronal plane
25-30 to table-top and film). Ilium & sacrum demonstrated without
superimpositionSI joint @ the center of collimated fieldSI joint, sacral ala and ilium inculded in the fieldLong axis of SI joint is aligned with the long axis
of collimated field
SI JOINT (POSTERIOR OBLIQUE)
ABNORMALITIES
Hip fracture
Hip prosthesis
Total hip replacement
The radiograph of total bilateral hip replacement.
# make sure tip of the hip prosthesis included in the radiograph.
DHS
Judet view