1. Imaging of the Pelvis and Hip
Sakti Srivastava, MBBS, MS
Associate Professor, Surgery
Chief, Division of Clinical Anatomy
Stanford University School of Medicine
SURG203 / LL / IMAGING / 2015

2. Bony pelvis

3. Female Pelvis (Sagittal image)
MR images
T2 weighted image
Sagittal plane
Fluid is white
Air is black
Fat is light gray
Soft tissue and bones= middle gray

4. Female Pelvis (Sagittal image)
1- Pubic symphysis
2- Bladder/ urethra
3- Uterus/ Vagina
4-Rectum
5- Sacrum/coccyx 5 4 3 2 1

5. Female Pelvis (Horizontal Section)
Axial plane 1 -Bladder 2- uterus 3- ovaries 4- rectum 1 2 3 4

6. Female Pelvis (Horizontal Section)
1- Uterine body 2- Vaginal cuff 3- Ovaries 4- Rectum 5- Hips 1 5 3 2 4

7. Hysterosalpingogram

8. Hysterosalpingogram
Uterus
Fallopian tubes

9. Male Pelvis- Sagittal Image
Bladder
Pubic symphsis
Prostate
Penis
Testes

10. Male pelvis (Coronal section)
1- Bladder 2- Urogenital diaphragm 3- Penis- Corpus cavernosa (2) Corpus spongiosa (1) 4- femoral head 5- psoas muscle 6- iliacus muscle 7- Obturator Internus mm 8 -Obturator Externus mm 5 6 4 1 7 8 2 3

11. Male pelvis (Horizontal Section)
1- Bladder 2- Seminal vesicles 3- Rectum Bony pelvis 4- Actabulum 5- Femoral heads 6- Coccyx 4 1 5 2 3 6

12. Bony pelvis

13. Hip Muscles – Coronal MR
1- Rectus femoris
2- Tensor fasciae latae
3 -Iliopsoas
4 Femoral artery and vein
5- Pubic symphysis 2 4 3 5 1

14. Hip Muscles – Coronal MR
1- Gluteus med/min
2- Vastus lateralis and intermedius
3- Iliopsoas
4- Obturator externus
5- Adductor mm.
6 Gracilis 3 1 4 6 5 2

15. Hip Muscles – Coronal MR
1- Iliotibial tract
2- Gluteus med/min
3- Vastus lateralis
4- Obturator Internus
5- Obturator externus
6- Gracilis
7- Adductor brevis/ magnus 2 1 4 5 7 6 3

16. Hip Muscles – Coronal MR
1 Gluteus max (med/min)
2 Quadratus femoris
3 Gemelli
4 Obturator internus
5 Levator Ani 1 5 3 4 2

17. Hip Muscles – Horizontal MR3
1- Gluteus maximus and minimus
2- Rectus femoris
3- Sartorius
4- Iliopsoas
5 -Acetabulum
6- Femoral head
7- Obturator internus
8- Vastus lateralis 2 4 8 5 6 7 1

18. Hip Muscles – Horizontal MR
1- Gluteus maximus and minimus
2- Rectus femoris
3- Sartorius
4- Iliopsoas
5- Obturator externus
6- Pectineus
7- Obturator internus
8 Vastus lateralis 3 2 6 4 8 5 7 1

19. Bony pelvis

20. Bony pelvis
Shenton’s line

21. Bony pelvis
Age: 1o years
Age: 1 year

22. Pelvic fractures

23. Pelvic fractures

24. Pelvic fractures

25. Pelvic fractures

26. Pelvic fractures

27. Pelvic fractures

28. CLINICAL CASE Intertrochanteric fracture
68 YEAR OLD,FEMALE
H/O SLIP AND FALL, INJURY TO RIGHT HIP
Intertrochanteric fracture
Common site of fracture in patients with decreased bone stock ( osteoporosis)
Major source of morbidity in elderly patients

29. CLINICAL CASE
Pre surgery
Surgical fixation

30. Central fracture dislocation
CLINICAL CASE
32 YEAR OLD,MALE
H/O MOTOR VEHICLE ACCIDENT
INJURY TO RIGHT HIP
Central fracture dislocation

31. CLINICAL CASE Posterior dislocation of hip joint
28 YEAR OLD,MALE
H/O MOTOR VEHICLE ACCIDENT
INJURY TO PELVIC AND LEFT HIP
Posterior dislocation of hip joint
Diastasis of pubic symphysis

32. CLINICAL CASE Congenital dislocation of hip joint
2 YEAR OLD, FEMALE
H/O DELAYED AND DIFFICUT WALKING
Congenital dislocation of hip joint
Developmental dysplasia of the hip