Radiologic Eval of Hip and Pelvis Flashcards Preview

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Flashcards in Radiologic Eval of Hip and Pelvis Deck (19)
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1
Q

list radiologic views and projections for the hip and pelvis that may be included in a routine exam

A
  1. Project
    1. AP of pelvis → bilateral hips
    2. AP of the Hip and proximal femur
    3. lateral frog leg
  2. Other possible
    1. axiolateral inferosuperior
2
Q

what can be viewed in the AP view of pelvis

A
  1. acetabular roof
  2. anterior rim
  3. posterior rim
  4. iliopubic line
  5. ilioischial line
  6. radiographic teardrop
3
Q

what can be viewed in AP view of the hip and proximal femur?

A
  1. positioning of head in acetabulum
    1. Shenton’s hip line
    2. iliofemoral line
    3. femoral neck angle
4
Q

what can be viewed in the lateral frog-leg view?

A
  1. expanse of femoral head
  2. greater and lesser trochanters from medial
5
Q

list indications/key findings for CT of the hip

A
  1. severe trauma
  2. fracture assessment
  3. loose bodies
  4. assess bone geometry/alignment
  5. other → CT arthrogram when MRI arthrogram contraindicated
6
Q

other info about CT of the hip

A
  1. best for bony alignment/pre-op planning, and fracture assessment
  2. basic protocol
    1. pelvis vs level of bilateral hips
    2. axial slices, reformatted for coronal and sagittal
7
Q

describe the basic protocol for MRI of the hip and what it is good for

A
  1. best for detecting lesions of the labrum, marrow cartilage, and soft tissues
  2. basic protocol:
    1. both hips and the pelvis
    2. T1 → define anatomy
    3. T2 → detect abnormal fluid
8
Q

list general indications/key findings of MRIs of the hip

A
  1. AVN
  2. occult fractures
  3. osteochondral defect (OCD)
  4. pediatric hip disorders
  5. athletic pubalgia
  6. femoroacetabular impingement (FAI)
  7. tears of the labrum
  8. tendinopathies
  9. sacral plexus abnormalities
9
Q

what is the cross-over sign?

A

indicated retroversion of the acetabulum (associated with anterior FAI)

9
Q

list different types of proximal femur fractures

A
  1. Intracapsular
    1. femoral head fracture
    2. subcapital fracture
    3. femoral neck fracture
  2. Extracapsular
    1. intertrochanteric fracture
    2. subtrochanteric fracture
    3. shaft fracture
10
Q

list ACR appropriateness criteria for the hip and pelvis

A
  1. chronic hip pain
  2. acute hip pain → suspected fracture
  3. imaging after total hip arthroplasty
11
Q

what initial imaging study is most appropriate for a pt with acute hip pain from a fall or minor trauma?

A

Radiography of hip and pelvis

12
Q

what follow up imaging study is most appropriate for a pt with acute hip pain from a fall or minor trauma after they have negative radiographs but a fracture is still suspected?

A

MRI pelvis and affected hip

CT pelvis and hips

13
Q

what is the first imaging test for a pt with chronic hip pain?

A

Pelvis and hip radiographs

14
Q

if radiographs were negative, equivocal or nondiagnostic; what follow-up study is most appropriate for a pt with chronic hip pain and there are suspected extra-articular noninfectious soft-tissue abnormalities such as tendonitis?

A

MRI hip

US hip

15
Q

if radiographs were negative, equivocal, or nondiagnostic; what follow-up study is most appropriate for a pt with chronic hip pain and suspected impingement?

A

MRI hip

CT arthrography hip

16
Q

if radiographs were negative, equivocal, or nondiagnostic; what follow-up study is most appropriate for a pt with chronic hip pain and suspected labral tear with/without clinical findings consistent with or suggestive of impingement?

A

MR arthrography hip

CT arthrography hip

17
Q

if radiographs were negative, equivocal, or showing mild osteoarthritis; what follow-up study is most appropriate for a pt with chronic hip and low back, pelvic, or knee pathology and you want to exclude the hip as the source?

A

MRI hip

image guided anesthetic +/- corticosteroid injection hip joint or surrounding structures

18
Q

what imaging should be performed following a THA for a follow-up of the asymptomatic pt?

A

Radiograph hip