1. Hip and Pelvis Chapter 6

2. Hip AP Facility IdentificationFacility Identification Correct Marker PlacementCorrect Marker Placement No Preventable ArtifactsNo Preventable Artifacts Correct Film Size (10 x 12 lw unless indicated)Correct Film Size (10 x 12 lw unless indicated)

3. Hip AP DensityDensity –Controlled by mAs –Overall the density is not too dark or too light ContrastContrast –Optimal kVp 75-85 –Bony trabecular patters and cortical outlines visualized as well as soft tissues (fat pads) of the hip are demonstrated

4. Hip AP Pelvis is in true AP projectionPelvis is in true AP projection –The ischial spine is aligned with the pelvic brim –The sacrum and coccyx are aligned with the symphysis pubis –The obturator foramen is open

5. Hip AP Detecting rotation toward the affected hipDetecting rotation toward the affected hip If the ischial spine is demonstrated without pelvic brim superimpositionIf the ischial spine is demonstrated without pelvic brim superimposition The sacrum and coccyx are rotated away from the affected hipThe sacrum and coccyx are rotated away from the affected hip The obturator foramen is narrowedThe obturator foramen is narrowed

6. Hip AP Detecting rotation away from the affected hipDetecting rotation away from the affected hip The sacrum and coccyx are rotated toward the affected hipThe sacrum and coccyx are rotated toward the affected hip The ischial spine is closer to the acetabulumThe ischial spine is closer to the acetabulum The obturator foramen is widenedThe obturator foramen is widened

7. Hip AP The femoral neck is demonstrated without foreshorteningThe femoral neck is demonstrated without foreshortening –The greater trochanter is demonstrated in profile laterally –The lesser trochanter is superimposed by the femoral neck

8. Hip AP The femoral head and acetabulum are in the center of the collimated fieldThe femoral head and acetabulum are in the center of the collimated field Any orthopedic appliance are located at the hip are included in their entirety.Any orthopedic appliance are located at the hip are included in their entirety.

9. Hip AP Gonadal shielding should be used on all males and females if it may be placed so that anatomy is not obstructedGonadal shielding should be used on all males and females if it may be placed so that anatomy is not obstructed

10. Hip Frog leg Lateral The pelvis is in a true AP positionThe pelvis is in a true AP position –The ischial spine is aligned with the pelvic brim –The sacrum and coccyx are aligned with the symphysis –The obturator foramen is open

11. Hip Frog leg Lateral The lesser trochanter is demonstrated in profile mediallyThe lesser trochanter is demonstrated in profile medially The femoral neck superimposes the greater trochanterThe femoral neck superimposes the greater trochanter –The neck if foreshortened and is ½ way between the femoral head and the lesser torchanter

14. Hip Axiolateral Danielus Miller Placing lead flat contact shields over the unused portion of the cassette will reduce scatter and help improve contrastPlacing lead flat contact shields over the unused portion of the cassette will reduce scatter and help improve contrast

15. Hip Axiolateral Danielus Miller The femoral neck is demonstrated without foreshorteningThe femoral neck is demonstrated without foreshortening The greater and lesser trochanters are about the same transverse levelThe greater and lesser trochanters are about the same transverse level

16. Hip Axiolateral Danulus Miller If the angle formed between the femur and the central ray is too large, the trochanter is demonstrated proximal to the lesser trochanter and is superimposed by a portion of the femoral neckIf the angle formed between the femur and the central ray is too large, the trochanter is demonstrated proximal to the lesser trochanter and is superimposed by a portion of the femoral neck If the angle is too small, the greater trochanter is demonstrated distal to the lesser trochanter. (this seldom occurs due to table top)If the angle is too small, the greater trochanter is demonstrated distal to the lesser trochanter. (this seldom occurs due to table top)

17. Pelvis AP Pelvis is demonstrated without rotationPelvis is demonstrated without rotation –The ischial spines are aligned with the pelvic brim –The sacrum and coccyx are aligned with the symphysis –The ilia and the obturator foramina are uniform in size and shape

18. Pelvis AP Male –vs- Female PelvisMale –vs- Female Pelvis –Male pelvis is more heart shaped The obturator foramina and acetabula are larger and more bulkyThe obturator foramina and acetabula are larger and more bulky –Female pelvis is more oval

19. Pelvis AP The femoral neck is demonstrated without foreshorteningThe femoral neck is demonstrated without foreshortening –The greater trochanter is demonstrated in profile laterally –The lesser trochanter is superimposed by the femoral neck

20. Pelvis AP Detecting rotation toward the affected hipDetecting rotation toward the affected hip If the ischial spine is demonstrated without pelvic brim superimpositionIf the ischial spine is demonstrated without pelvic brim superimposition The sacrum and coccyx are rotated away from the affected hipThe sacrum and coccyx are rotated away from the affected hip The obturator foramen is narrowedThe obturator foramen is narrowed

21. Pelvis AP Detecting rotation away from the affected hipDetecting rotation away from the affected hip The sacrum and coccyx are rotated toward the affected hipThe sacrum and coccyx are rotated toward the affected hip The ischial spine is closer to the acetabulumThe ischial spine is closer to the acetabulum The obturator foramen is widenedThe obturator foramen is widened

22. Pelvis AP All anatomy is included on the filmAll anatomy is included on the film –Inferior sacrum is in the center of the film –The ilia, symphysis ischia acetabulum, femoral necks and heads, greater and lesser trochanter are included on film

27. THE END