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14 Cards in this Set
- Front
- Back
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axiolateral hip (HB - Danelius-Miller) |
- displacement and rotation of femoral head; proximal femoral # - CR perp to femoral neck of affected side; mid femur (NOF well visualised - otherwise, will be foreshortened) - body: patient supine - part: flex and elevate unaffected leg so that thigh is in near vertical position, support - MSP perp to tabletop - place IR in holder in crease above crest and adjust so that it is parallel to NOF and perp to CR - if trauma, do not internally rotate leg - int rot: LT visible on inferior aspect - ext rot: GT visible on inferior aspect of femur |
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AP pelvis |
body: supine with legs extended, arms abducted away from torso part: rot: MSP perp - check ASIS equidistant from IR; tilt: patient lying flat on table; heels apart and feet rotated internally aprox 15 degrees CR: between ASIS and SP (Charnley, at SP) collimate: include top of crests and prox femur breathing: suspended respiration |
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AP hip |
position as for AP pelvis, centre to affected hip at NOF -if ischial spine is visible beyond pelvic brim, patient is rotated with thatside closer to IR - if ischial spine is closer to acetabulum, and obsturators open, patient is rotated away from side of interest - internal rot of feet: lessertrochanter is barely visualised on medial aspect of femurR, NOF is visualised ext rot: lessertrochanter is well visualised on medial aspect, NOF superimposed by GT |
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frog leg (mediolateral hip) |
- CI: DDH, lateral for paeds - flex knees 90 degrees - place plantar surfaces together and abduct both femora 45 degrees from vertical - CR 7.5 cm below ASIS - abduction: GT over NOF, which is foreshortened; LT below medial margin of femora - 20 degrees abd: NOF better demonstrated, GT in profile laterally - more than 45 degrees: NOF obscured by GT, LT seen in profile medially - looking at acetabulum for dislocation of femoral heads |
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modified mediolateral hip (Lauenstein) |
24 x 30 - foreshortens neck but demonstrates head and acetabulum well - rotate patient on affected side till femur in contact w/ tabletop, sponge support raised side - flex knee and hip on affected side - CR to mid femoral neck - closes obturator, large ischial spine visible - NOF partially superimposed by GT and LT visualised medially |
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AP femur |
35 x 43 cassette - rotate leg interally 5 degrees for true AP - or 15 degrees for prox - CR perp to femur and IR, midpoint of IR - rot: medial half of fib superimposed by tibia - internal rot: fibula free of superimposition - joint space not open due to divergence - patella slightly to medial femur |
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lateral femur |
- flex knee 45 degrees - place unaffected leg behind to prevent over-rot - CR perp to femur - joint not open and condyles not superimposed due to divergent beam - open femoralpatellar joint space - under-rot: GT lateral, fib superimposed - over-rot: LT medial, fib free of superimposition |
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axial pelvic inlet |
- assess ant/post displacement of each hemipelvis; # pelvic ring - can elevate knees for comfort - AP pelvis with 40 degree caudad tilt - CR at ASIS - rot: SP and sacrum alignment - tilt: obturators not visible |
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axial pelvis outlet |
- assess sup/inf displacement of each hemipelvis; # pubic/ischial rami; SIJS (widening = #) - 30-40 degrees cephalad - CR 5 cm distal to PS - rot: obturators - tilt: SP superimposed over sacrum |
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acetabulum projections (Judet) |
- assess obturator ring, # of iliopubic column and post rim of acetabulum - 45 degree oblique with affected side raised - CR head of femur - MVA - knee goes forward and impacts on soemthing, pushes femur into acetabulum - OR 45 degree with affected side down - assess # ilioishial column, iliac wing and ant rim of acetabulum |
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PA pubic symph |
- weight bearing one side then other - ? abnormal motion of SIJs - change in alignment of PS |
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leg length |
ASIS to ankles long FFD for anatomy of interest variable FFD so use filter |
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clinical indications |
- # or dislocation - inflammatory or infectious disorders (RA, OA, infectious arthritis, osteomyelitis - bone marrow) - congenital and hereditary abnormalities (osteopetrosis, osteogenisis imperfecta) - metabolic bone disease (osteoporosis, osteomalacia, Ricket's, Paget's) - benign bone tumours (osteochondrosis, enchondromas, giant cell tumour) - malignant bone tumours (sarcoma, multiple myeloma) - foreign bodies |
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modified axiolaterl hip |
- pull patient across to edge of table and use bucky tray to hold 5cm below tabletop - angle tube 12-20 degrees from vertical and ensure IR is perp to CR - angle CR mediolaterally as needed so that it is perp to NOF, angle posteriorly 15-20 degrees from horizontal |
