Wednesday, 25 April 2012

Pelvis

Hip Judets view of Acetabulum(1)

Indications for imaging
Trauma especially for fractures of the acetabulum
Anatomy  Demonstrated
Acetabulum

 Pelvis  Acetabulum Anatomy
Basic Patient Position
The patient lies supine on the table with the midsaggital line in the center of the table.
The affected side is raised 45 degrees and supported on pads with the legs extended or minimally flexed to aid support.

A second projection may be made  with the patient rotated 45 degrees onto the affected side and the central ray directed to a point midway along an imaginary line from the ASIS to the symphysis on the affected side.


 Pelvis Hip Judet's view Patient Position
Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London

Radiation protection
There are many local rules for gonad protection however the following should be taken into account. The 28 day rule should be applied for female patients.
In males direct lead rubber gonad protection can be applied at all times
In females direct lead rubber gonad protection is generally not advised on the first examination, however if the patient is subsequently examined gonad protection may be used if the area of interest is not obscured.
On small patients the omission of a grid will reduced the exposure.
Central Ray
The vertical central ray is centered 2.5 cm below and medial to the ASIS of the affected (raised) side.
Exposure Factors
Kv mAS FFD (cm) Grid Focus AEC Cassette
85 25 100 Yes Broad/Fine Yes 24 x 30 cm
Evaluation of the Image
ID and markers must be present and correct in the appropriate area of the film
Evidence of collimation on four sides equally around the centering point.
Optimal exposure should penetrate all the bone structures and contrast should be low enough to visualise fully the bone and soft tissue structures.
The femoral head and neck should be in profile with Acetabular margin and fovea well delineated.


 Hip Rt Judet's View Radiograph
Related Projections
Pelvis AP
Pelvis - Hip Lateral
Additional modalities
CT

1 Ref: Judets View of Acetabulum, Radiography Today  September 1989

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