Hips and Pelvis Unit 7

What landmarks should be visible on an AP pelvis radiograph?

-crest of ilium -ASIS -pubic symphysis -greater trochanter -ischial tuberositites

How can you evaluate an AP pelvis radiograph for possible rotation (5)?

-symmetric ilia alae -sacrum and coccyx aligned with pubic sym. -greater trochanters in profile -both greater trochanters equidistant from pubic sym. -symmetric obturator foramina

What is the correct CR location for an RPO of the SI jt.?

1" medial to left ASIS (elevated side)

Describe how to locate the neck of the femur using landmarks on the pelvis:

1) draw an imaginary line between the ASIS and pubic symphysis 2) bisect line midway and draw a perpendicular line diagonally towards hip joint (about 2.5'')

Osteopetrosis

Increased density of atypically soft bone

Congenital hip dysplasia

Malformation of the acetabulum causing displacement of the femoral head

Multiple myeloma

Malignant neoplasm of plasma cells involving the bone marrow and causing destruction of the bone

Chondrosarcoma

Malignant tumor arising from cartilage cells

How should the leg and foot be positioned for an AP pelvis radiograph?

Medially rotated 15 - 20 degrees

Metastases

Transfer of a cancerous lesion from one area to another

What is (a.) the key anatomical structure on an X-table lateral hip radiograph and (b.) how can this be used to determine how this radiograph should be positioned for viewing?

a. ischial tuberosity b. ischial tuberosity should be facing down

The fusion of the the three parts of the hip bone takes place around what structure?

acetabulum

The lesser trochanter is located on which aspect of the femur?

posteromedial aspect

What is the name of the articulation between the two pubic bones?

pubic symphysis

Name the exams done for a Right Hip with possible fx:

-AP with no lower limb rotation -Axiolateral (x-table lateral)

Name the exams done for a Left Hip, post reduction:

-Axiolateral (x-table lateral) -Judet (RPO) IF DOC. REQUESTS

List the functions of the greater and lesser pelvis and the other names they are known by.

-Greater (aka false) supports the abdominal viscera -Lesser (aka true) serves as the birth canal

List at least 3 differences between the structure of the male and female pelvis and describe:

1. Pubic arch: females = obtuse angle males = acute angle 2. Pelvis depth: females = shallow males = deep 3. Pelvic brim: females = wide males = narrow 4. Iliac wings: females = broad males = narrow 5. Bone structure: females = thinner/lighter males = thicker/heavier

What are the two primary parts of the ilium?

1. body 2. alae

Name the articulations found in the pelvic girdle along with their classification and movement type (if applicable):

1. hip joint (2) - diarthrodial, ball & socket 2. pubic symphysis (1) - amphiarthrodial, n/a 3. sacroiliac (2) - amphiarthrodial, n/a

List the 3 divisions of the hip bone and the change they undergo from child to adult:

1. ilium 2. pubis 3. ischium *They are separated by cartilage at birth and later fuse together to form acetabulum.

List the 4 bones comprising the pelvic girdle:

1. right hip bone 2. left hip bone 3. sacrum 4. coccyx

What are the other 4 names for an X-table lateral hip projection?

1. translateral 2. axiolateral 3. Smith-Peterson 4. Dannelius-Miller

What are the projections located on the anterior and posterior aspects of the alae?

Anterior: ASIS & AIIS Posterior: PSIS & PIIS

Dislocation

Displacement of a bone from the joint space

Fracture

Disruption in the continuity of bone

Legg-Calvé-Perthes disease

Flattening of the femoral head owing to vascular interruption

Osteoarthritis or degenerative joint disease

Form of arthritis marked by progressive cartilage deterioration in synovial joints and vertebrae

How many degrees and which oblique should be taken for a left SI jt. and a right SI jt.?

Left : RPO with 25-30 degrees Right: LPO with 25-30 degrees

Osteoporosis

Loss of bone density

Tumor

New tissue growth where cell proliferation is uncontrolled

What is the name for the largest foramen in the human body?

Obturator foramen

Exams of the pelvic outlet (inferior aperture) and inlet (superior aperture) used to be taken during active labor. What were these exams known as and why were they done?

Pelvimitry; They were done to determine if the baby's head could fit through them. (ultrasound is now used instead)

Slipped epiphysis

Proximal portion of femur dislocated from distal portion at the proximal epiphysis

Ankylosing spondylitis

Rheumatoid arthritis variant involving the SI joints and spine

What 2 parts of the hip bone constitute the majority of the acetabulum?

The ischium and ilium

What two portions form the obturator foramen?

The rami of the ischium and pubis

What are the greater and lesser pelvis separated by?

The superior aperture which extends from the sacral promontory to the upper margin of the pubic symphysis.

Paget disease

Thick, soft bone marked by bowing and fractures

How many borders are present on an ala?

Three: anterior, posterior, and superior

Name the two important positioning landmarks found on the ilium:

iliac crest and ASIS (anterior superior iliac spine)

The hip bone is divided further into two distinct areas which are used to identify fractures around the acetabulum. What are these?

iliopubic column and the ilioischial column

What is the most inferior structure of the pelvis?

ischial tuberosities (body rests on this in the seated position)

What are the two additional terms sometimes used for the hip bone?

os coxae and innominate bone

What is the superior aperture and inferior aperture also called?

superior aperture = inlet inferior aperture = outlet