Pelvis Hip PP

Question 1

What must be included in the final image for pelvis and hip examinations?

Answer 1

Right or left side markers and other required ID markers

Avoid using digital annotation to place side markers on images.

Question 2

What is the standard SID for pelvis and hip examinations?

Answer 2

40 inches

SID stands for Source-to-Image Distance.

Question 3

What collimation size is required for a pelvis examination?

Answer 3

14 x 17 inches (35 x 43 cm) and 1 inch (2.5 cm) beyond the skin shadow on the sides for smaller patients.

Question 4

What collimation size is required for a hip examination?

Answer 4

10 x 12 inches (24 x 30 cm)

Question 5

During what phase should exposures be taken?

Answer 5

Suspended respiration

Question 6

What are the general patient positions for ambulatory and nonambulatory patients?

Answer 6

Ambulatory: Supine on x-ray table; Nonambulatory: Use proper transfer techniques to table or use grid IR if transfer is not possible.

Question 7

What artifacts should be removed from the anatomy of interest?

Answer 7

Undergarments, clothing

Provide a gown for the patient.

Question 8

What does the general procedural guidelines for pelvis and hip examinations include?

Answer 8

Patient preparation, general patient position, respiration, IR/collimation size, SID, ID markers, radiation protection, patient instructions.

Question 9

What should be explained to the patient before the examination?

Answer 9

Positions and breathing instructions; respirations are suspended for exposure.

Question 10

What is the patient position for the AP oblique femoral necks (modified Cleaves)?

Answer 10

Supine with MSP centered to IR, no rotation of pelvis, ASIS equal distance from tabletop, flex hips and knees, abduct thighs approximately 45 degrees.

Question 11

What evaluation criteria should be met for an AP pelvis and upper femora?

Answer 11

No rotation of pelvis, symmetric ilia, symmetric obturator foramina, ischial spines equally seen, proper rotation of proximal femora.

Question 12

What structures are shown in an AP pelvis and upper femora examination?

Answer 12

Pelvis and the head, neck, trochanters, and proximal one-third or one-fourth of the femur.

Question 13

What is the central ray direction for the AP pelvis and upper femora?

Answer 13

Perpendicular to IR, 2 inches (5 cm) inferior to ASIS and 2 inches (5 cm) superior to pubic symphysis.

Question 14

What angle does the femoral neck project from the body in an average adult?

Answer 14

15-20 degrees anteriorly and 120-130 degrees superiorly.

Question 15

What are the three bones that form the acetabulum?

Answer 15

Ilium, ischium, pubis.

Question 16

What is the proper positioning of the lower limbs for the AP projection of the pelvis?

Answer 16

Medially rotated 15 to 20 degrees.

Question 17

What are the components of the hip bone?

Answer 17

Pubis, ilium, ischium.

Question 18

What is the function of the pubis in the hip bone?

Answer 18

Forms approximately one-fifth of anterior acetabulum.

Question 19

Which anatomical landmarks are important for localizing the hip joint?

Answer 19

Iliac crest, ASIS, pubic symphysis, greater trochanter, ischial tuberosity, tip of coccyx.

Question 20

Which projection requires the patient to abduct the thighs 45 degrees laterally?

Answer 20

AP oblique femoral necks (modified Cleaves).

Question 21

What should be centered to the midline of the grid for the superoinferior axial inlet anterior pelvic bones?

Answer 21

MSP.

Question 22

What is the central ray direction for the AP axial outlet anterior pelvic bones for men?

Answer 22

Angle 20-25 degrees cephalad.

Question 23

What type of joint is the pubic symphysis?

Answer 23

Cartilaginous, slightly movable joint.

Question 24

What is the highest point of the greater trochanter aligned with?

Answer 24

Midpoint of the hip joint and coccyx.

Question 25

What is the significance of the intertrochanteric crest?

Answer 25

It is a prominent ridge located posteriorly between the trochanters at the base of the neck.

Question 26

Which examination method is contraindicated if fracture or pathology is suspected?

Answer 26

AP oblique (modified Cleaves method).

Question 27

What is the average angle of the femur in children compared to adults?

Answer 27

Wider angle in children (neck more vertical) compared to adults.

Question 28

What is the Axiolateral hip projection also known as?

Answer 28

Danelius-Miller method ## Footnote This method is used for imaging the hip joint.

Question 29

What does the AP oblique acetabulum projection refer to?

Answer 29

Judet method ## Footnote This method is used to visualize the acetabulum in an oblique position.

Question 30

What is the purpose of the AP oblique femoral necks projection?

Answer 30

Modified Cleaves method ## Footnote This method is used to obtain images of the femoral necks.

Question 31

Identify the projection for the lateral hip using the Hickey method.

Answer 31

Lateral hip (Hickey) ## Footnote This method provides a lateral view of the hip joint.

Question 32

Identify the projection for the lateral hip using the Lauenstein method.

Answer 32

Lateral hip (Lauenstein) ## Footnote This method is another approach for lateral imaging of the hip.

Question 33

What is the central ray direction for a bilateral pelvis projection?

Answer 33

Perpendicular to MSP at level 1 inch (2.5 cm) above pubic symphysis ## Footnote MSP stands for mid-sagittal plane.

Question 34

What is the radiation field size for a bilateral pelvis projection?

Answer 34

14 × 17 inches (35 × 43 cm) crosswise ## Footnote This field size is used for proper coverage of the pelvis.

Question 35

What structures are shown in an AP hip projection?

Answer 35

* Head * Neck * Trochanters * Proximal one-third of the body of the femur ## Footnote These structures are essential for assessing the hip joint.

Question 36

What is the required patient position for the AP hip projection?

Answer 36

Supine ## Footnote The pelvis should not be rotated.

Question 37

In the AP oblique acetabulum projection (Judet), what is the patient position?

Answer 37

Recumbent posterior oblique position (RPO or LPO) with affected hip up ## Footnote This positioning helps visualize the acetabulum.

Question 38

What is the purpose of the collimation in radiographic projections?

Answer 38

To limit radiation exposure and focus on the area of interest ## Footnote Proper collimation is critical for image quality.

Question 39

What is the central ray entry point for the AP oblique acetabulum projection?

Answer 39

2 inches (5 cm) inferior to ASIS of affected side ## Footnote ASIS stands for anterior superior iliac spine.

Question 40

What is the evaluation criterion for the Lauenstein method?

Answer 40

* Evidence of proper collimation * Regions of the ilium and pubic bones * Hip joint * Proximal one-third of the femur * Femoral head visible through the acetabulum * Entire long axis of femoral neck not foreshortened * Greater trochanter in profile * Bony trabecular detail ## Footnote These criteria ensure the quality of the radiographic image.

Question 41

What is contraindicated in the Lauenstein method?

Answer 41

Fracture or pathology ## Footnote This method should not be used if such conditions are suspected.

Question 42

What is the central ray direction for the lateral hip (Hickey) method?

Answer 42

Cephalic angulation of 20 – 25 degrees entering 1 inch (2.5 cm) inferior ## Footnote This angulation helps visualize the hip joint.

Question 43

What is the patient position for the Axiolateral hip projection?

Answer 43

Supine with pelvis elevated for thin patients ## Footnote The unaffected limb's knee and hip should be flexed.