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