Chapter 7 Hip and Pelvis

Pelvis Connects lower extremities to the axial skeleton Consists of –____________ –1 sacrum –____________ _____________ – 2 hip bones only

Hip Bones _________ Ischium ________ ____________ – The area of fusion for the 3 bones.

Ilium _______ –Large winged area Body –Inferior to the Ala. Includes superior acetabulum ____________ _______, AIIS, PSIS, PIIS.

Ischium Inferioposterior to acetabulum. ___________ – Posterior acetabulum to ischial tuberosity __________ – Anterior portion off of ischial tuberosity

Ischium Ischial ____________ –Rounded, rough area at the border of lower body and Ramus Ischial ____________ – Posterior bony protrusion off acetabulum Greater/Lesser _____________ – Depression superior and inferior to ischial spine

Pubis Anterioinferior to acetabulum. ________ –Anteriorinferior acetabululum to superior ramus Superior __________ – Anterior medial extensions meeting to form symphysis pubis. Inferior ___________ – Inferioposterior extension off symphysis pubis to Ischial Ramus _______________ – Hole formed by ischium and pubis

True and False Pelvis ___________ –Area surrounded by bone –_______to pelvic brim –Birth Canal –Inlet and Outlet ____________ –Area formed by Alae –______ to pelvic brim

Male vs. Female Pelvis Male –Narrower –Deeper –___________ –______pubic arch –Narrow inlet –______Obturator Foramen Female –Wider –___________ –______pubic arch –Larger inlet –_______ Obturator Foramen

Joints of the Pelvis Sacroiliac Joint ________ – Amphiarthrodial synovial, sacrum to pelvis ____________ Pubis – Amphiarthrodial cartilaginous. Rt and Lt pubic bones Union of Acetabulum – Synarthrodial cartilaginous. 3 fused hip bones _____________ – Diarthrodial synovial spheroid.

Imaging the Pelvis Routine AP 14 x 17 XW 40” SID 75 kV

AP Pelvis Pt __________ Internally rotate legs ___________ Center Midline between _______ and __________Pubis Top of Cassette ____________Crest Collimate to skin If Trauma do not rotate legs *****

Proximal Femur __________ – Round process ___________ – Depression in the center of the head Neck – Area between shaft and head Acetabulum –Cavity for head of femur

Proximal Femur Greater _______________ – Superiolateral prominence Lesser _______________ – Medioposterior prominence inferior to greater trochanter. Intertrochanteric Crest – Depression between trochanters

Femur Angle Not ________ Angle of positioning importance –Head and neck = ___________angle. Rotate legs Internally (Pigeon Toe) to get ______________

Fracture Sign Look at the _________ –For symmetry If one is _________ and one is _______rotated, possible fracture.

Hip Imaging Routine AP Pelvis AP Unilateral Hip Lateral –Frog Leg –X-table lateral 40” SID 75 kV

AP Hip Patient Supine Rotate Leg ____________ CR directed __________to femoral neck ___medial and ___ distal to _______

Frog leg Lateral Pt Supine Flex knee and externally ____________ A sponge may help Center to Femoral Neck –Draw ___________between ASIS and Symphysis Pubis and _________ perpendicular to line

X-table Hip Pt Supine Do not move __________ Unaffected Leg ______________. Can put leg on collimator Use _____________grid parallel to femoral neck Adjust collimator to be __________ to cassette.

Sacroiliac Joint Imaging Place patient into ____________ Posterior Oblique The joint of interest is _________ –______ for left SI joint Direct CR ____ medial to upside ASIS