Babeh Edi

Pelvis Hip Lateral

Indications for imaging Congenital abnormalities, Trauma, degenerative disease, carcinoma primary and secondary, pathologies e.g. Perthes disease, slipped femoral epiphyses. Anatomy  Demonstrated Femoral head and neck, acetabulum Pelvis Hip Lateral Anatomy Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London Basic Patient Position The patient lies supine on the table, A.S.I.S.s equidistant from the table top with the midsaggital line in the center of the table, the affected limb is turned inwards 10 degrees and supported using a sandbag or similar. The unaffected limb is flexed 90 degrees at the hip and knee and supportted. A 24 x 30 cm grid is placed upright with the medial side well into the waist and parallel to the neck of the femur. A small pad under the pateienrts buttocks raising the of the table may ease positioning.  Pelvis Hip lateral 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 horizontal central ray is angled 45 degrees cranialy and centred to the crease of the hip to the centre of the femoral neck (located a 3 cm below a imaginary line from the ASIS to the symphysis pubis) at the level of the greater trochanter which is palpable laterally. Exposure Factors Kv mAS FFD (cm) Grid Focus AEC Cassette 85 25 100 Yes Broad/Fine Yes 35 x 43 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. Limits of the examination, Superiorly the femoral head, inferiorly the ischial tuberosity, medialy the acetabulum and lateral the proximal femoral shaft. The acetabulum, femoral head and neck should be clearly demonstrated with the greater trochanter overlying only the distal portion of he femoral neck, the lesser trochanter shoulder only just be visible. Optimal exposure should penetrate all the bone structures and contrast should be low enough to visualise fully the bone and soft tissue structures. Pelvis Hip Rt. Lateral Radiograph (From Merrills Atlas) Related Projections Pelvis AP Pelvis "frogs" Lateral. Acetabular projections e.g. Judet's view. Additional modalities RNI CT MRI