Pelvic Test Procedures

3

The pelvic girdle has ___ fused bone.

1/3; acetabulum

AP Hip •Evidence of proper collimation •Regions of the ilium and pubic bones adjoining the pubic symphysis •Hip joint •Proximal __/__ of the femur •Femoral head, penetrated and seen through the ______________. •Entire long axis of the femoral neck not foreshortened

femoral neck; 10 x 12

AP Hip (Cont.) •CR -Perpendicular to _________ _____. -Use localization technique described previously -Adjustment may be necessary if orthopedic device is present •Collimated field -___x___ inches

15-20; parallel

AP Hip: •Patient position -Supine •Part position -No rotation of pelvis •ASIS-to-tabletop distance equal on both sides -Medially rotate lower limb and foot approximately ___ to ___ degrees •Places femoral necks __________ to IR

medial

AP Oblique Femoral Necks (Modified Cleaves): •Evidence of proper collimation •No rotation of the pelvis, as demonstrated by a symmetric appearance •Acetabulum, femoral head, and femoral neck •Lesser trochanter on the ________ side of the femur

MSP;

AP Oblique Projection Modified Cleaves Method :"Frogleg" •Supine •______ of body to midline of grid •Flex pts _______ and rest hands on upper chest •No rotation of the pelvis/ASIS equal distance from table •Bilateral or unilateral

fracture; affected

Lateral Hip (Lauenstein) Note: This method is contraindicated if ___________ or pathology is suspected. •Patient position -Rotate slightly toward __________ side to an oblique position

Hip; acetabulum; femoral; greater

Lateral Hip (Lauenstein) •Evidence of proper collimation •Hip joint centered to the radiograph •____ joint, _____________, and ________ head •Femoral neck overlapped by the ___________ trochanter in the Lauenstein method •Soft tissue and bony trabecular detail

ASIS; pubic symphysis; 10x12

Lateral Hip (Lauenstein) (Cont.) •CR -Perpendicular through hip -Enters midway between ______ and ______ ___________. •Collimated field -__ x __ inches

Flex; 45; laterally

AP Oblique Projection Modified Cleaves Method: •Unilateral •Part position for unilateral -Center ASIS of affected side to midline of grid -_____ affected hip and knee -Draw foot up to opposite knee as much as possible -Abduct thigh approximately ___ degrees ________.

MSP; ASIS; Medially; 15-20; parallel; 1-1½

AP Projection (Pelvis) -_______ of body centered to midline -Equal _______-to-table distance on both sides -__________ rotate feet and lower limbs ___ to ____ degrees •Places femoral necks _________ with IR •Do not rotate if trauma or other pathology suspected •Upper border of IR ___ to __/__ inches (2.5 to 3.8 cm) above crests

2; 2

AP Projection (Pelvis) •CR Perpendicular to IR ( ___ inches superior to pubic & ___ inches inferior to ASIS)

thin; vertical; 15-20; medially

Axiolateral Hip (Danelius-Miller (Crosstable) •Patient position -Supine •Part position -Elevate pelvis for _____ patients -Flex knee and hip of unaffected limb to place thigh _________. -Rest unaffected leg and foot on a support -No rotation of pelvis -Rotate affected limb ___ to ___ degrees __________.

acetabulum; greater; lesser; greater; inverted

Axiolateral Hip (Danelius-Miller) •Evidence of proper collimation •Hip joint with the _______________. •Femoral neck without overlap from the _________ trochanter •Small amount of the ________ trochanter on the posterior surface of the femur •Small amount of the ________ trochanter on the anterior and posterior surfaces of the proximal femur when the femur is properly ___________.

iliac crest; body

Axiolateral Hip (Danelius-Miller) (Cont.) •IR -Vertical with upper border in crease above ______ ________. -Angle lower border away from _______ until parallel with femoral neck -Support IR in position

femoral neck; 10 x 12

Axiolateral Hip (Danelius-Miller)(Cont.) •CR -Horizontal and perpendicular to long axis of ________ ____. •Collimated field -___x___ inches (24 x 30 cm)

Ischial; trabecular

Axiolateral Hip (Danelius-Miller)(Cont.) •_________ tuberosity below the femoral head and neck •Soft tissue shadow of the unaffected thigh not overlapping the hip joint or proximal femur •Any orthopedic appliance in its entirety •Soft tissue and bony ___________ detail

low; ilium

Common errors when positioning pelvis: •Film centered too _____ and crest of the ______ is clipped.

internally

Common errors when positioning pelvis: •Legs not _________ rotated.

Rotation; pelvis; ilia

Common errors when positioning pelvis: •___________ of the _______ which gives an asymmetrical appearance of the _____, as well as, as the two obturator foramina

AP; Lateral (mediolateral) (Lauenstein and Hickey methods); Axiolateral

Essential Projections: Hip •____ •__________ (_____________) (Lauenstein and Hickey methods) •______________ (Danelius-Miller method)

1; pubic symphysis; MSP; 1

AP Oblique Projection Modified Cleaves Method: •Bilateral -Draw feet up as much as possible -Abduct thighs equally and maximally -Place soles of feet together for support •Center IR ___ inch (2.5 cm) above _______ ____________. •CR -Perpendicular to _____ at level __ inch (2.5 cm) above pubic symphysis

Perpendicular

AP Oblique Projection Modified Cleaves Method: •Unilateral •CR -_______________ to femoral neck

ischium; ilium; femora; acetabulum

Following should be seen on Lateral Pelvis: •Entire pelvis and proximal femora •Sacrum and coccyx •Superimposed posterior margins of the ________ and ______. •Superimposed _________. •Superimposed _______________ shadows •Pubic arch unobscured by the femora

obtuse

Gender Differences in Pelvic Anatomy: •Females Angle at pubic symphysis is __________.

rounded

Gender Differences in Pelvic Anatomy: •Females Inlet is larger and more __________.

Wider; lighter

Gender Differences in Pelvic Anatomy: •Females ________, shallower, _________.

acute

Gender Differences in Pelvic Anatomy: •Males Angle at pubic symphysis is ________.

Heavier; deeper

Gender Differences in Pelvic Anatomy: •Males _________, narrower, __________.

cartilage

Hip Bones: Separated by __________ in youth but fuse into one bone in adulthood.

acetabulum

Hip Bones: These form the _______________-cup-like socket that receives the head of femur.

Obturator

Hip Bones: ______________ foramen: large opening in the lower part of the innominate bone.

ilium; pubis; ischium

Hip Bones: Consist of _______, _______, and _________.

acetabular

Hip Joint Localization Midpoint directly above __________ cavity center dome.

ASIS; pubic symphysis

Hip Joint Localization Palpate _______ and superior margin of _______ ____________.

1½; 2½

Hip Joint Localization: Femoral head = __/__ inches (3.8 cm) distal Femoral neck = __/__ inches (6.4 cm) distal

parallels

Hip Joint Localization: Line _________ femoral neck

anterior, posterior and superior

Ilium Ala has 3 borders. What are they???

three

Ilium Ala has ________ borders.

superiorly; prominence

Ilium Ala projects _____________ from the body to form the ________________ of the hip.

two fifths

Ilium Body of ilium forms _____ _______ of the acetabulum superiorly.

ala

Ilium Consist of a body and broad curved portion called the ______.

Anterior superior iliac spine (ASIS) Anterior inferior iliac spine (AIIS) Posterior superior iliac spine (PSIS) Posterior inferior iliac spine (PIIS)

Ilium: Anterior and posterior borders present 4 prominent projections. What are they?

4

Ilium: Anterior and posterior borders present ___ prominent projections.

sciatic notch

Ilium: Posterior inferior part ends in the greater ________ ______.

iliac crest

Ilium: Superior margin is called the _____ ______.

2/5

Ischium: Body forms __/__ of acetabulum posteriorly.

body; ischial

Ischium: Consist of a ______ and _______ ramus.

femora; acetabula; Synovial

Joints of the pelvis: Hip joints(2): Articulation of the head of the ________ with the ____________. ____________, ball-and-socket type.

ilia; sacrum; gliding

Joints of the pelvis: Sacroiliac joints(2) Articulation between the right and left ______ and the ________. Irregular, _________ type

pubic bones; Cartilaginous

Joints of the pelvis: Symphysis Pubis (1): Junction of right and left _______ ______ in the midline. _______________, slightly movable joint

cephalic; femoral neck

Lateral Hip (Hickey) •Evidence of proper collimation •Hip joint centered to the radiograph •Hip joint, acetabulum, and femoral head •With _________ angulation in the Hickey method, the ________ _____ free of superimposition •Soft tissue and bony trabecular detail

20; cephalic; 10 x 12

Lateral Hip (Hickey) •Patient and part position are same as for Lauenstein method •CR -Angled ____ degrees _________. -Enters hip joint •Center IR to CR •Collimated field -___ x ___ inches

Right angle; parallel

Lateral Hip (Lauenstein) (Cont.) •Part position -Center affected hip to midline of grid -Flex affected knee and draw thigh to almost _____ _______ to hip -Body of femur _________ to table -Support opposite hip and knee

midcoranal; femora; parallel

Lateral Projection (Pelvis) •Lt or Rt •Center _____________ plane of body to midline of grid •Extend thighs to prevent ________ from obscuring pubic arch. •Vertebral column __________ with tabletop/can use support

ASIS; Knees; Suspend

Lateral Projection (Pelvis) •True lateral/______ in same plane •_______ on top of each other •____________ respiration

horizontal; coccyx

Localizing Anatomy (Cont.) Highest point of greater trochanter lies in same _____________ plane as the midpoint of the hip joint and __________.

pubic symphysis

Localizing Anatomy (Cont.) Most prominent point of greater trochanter is in same horizontal plane as the _______ ____________.

Os coxae Innominate Hip bones

Other names of the pelvis girdle include:

two hip

Pelvic Girdle: Composed of only the _____ _____ bones

Ilium Ischium Pubis

Pelvic Girdle: Each hip bone or pelvic girdle has three parts. What are they?

four

Pelvis: Consists of ______ bones

base; girdle

Pelvis: Serves as a ______ for the trunk and as a ________ for the attachment of the lower extremities.

captitis femoris

Proximal Femur: Small depression at the center of the femoral head attaches to the ligament ________ ___________.

Head Neck Greater trochanter Lesser trochanter

Proximal femur includes:

age; sex; stature

Proximal femur: -Neck Angle depends on ____, ____, ________.

15-20; 120-130

Proximal femur: -Neck Average angle ___ to ___ degrees superioly and angle of _____ to _____ degrees to the long axis of the femoral body.

1/5

Pubis Body forms _____ of acetabulum anteriorly.

ramus; ramus

Pubis Consist of a body, superior ______ and inferior _______.

ischial; pubis inferior

Pubis: Obturator foramen is formed by the junction of _________ ramus and ______ __________ ramus

Right and left hip bones Sacrum Coccyx

What are the 4 bones of the pelvis?

Pubis Bone

_______ _____-forms the anterior part of the acetabulum and the lower anterior part of the innominate bone. It contains a body, two rami, and pubic arch

Ilium

________-forms the upper part of the acetabulum, and all of the innominate bone above the socket. It contains a body, an ala or wing, iliac fossa, iliac crest, and 4 spines.

Ischium

___________-forms the lower posterior of the acetabulum and that part of the innominate bone below and behind this cavity. It has a body, 2 rami, a spine, and a tuberosity.