Femur and Pelvic Girdle
Femur and Pelvic Girdle
Male:
AP Femur*
Position
• Supine, femur centered to midline of table or grid IR
• Rotate entire lower limb internally ≈5° for AP of midfemur and distal femur, and 15° internally for true AP to include hip.
• Lower border of IR ≈5 cm (2″) below knee to include knee joint adequately (see AP Unilateral Hip for proximal femur, p. 156).
Horizontal Beam Lateral Femur*
(Trauma Midfemur and Distal Femur)
Note: For proximal femur injuries, take axiolateral (Danelius-Miller method) hip.
AP Bilateral Hips*
Note: For AP pelvis centering, see p. 291 in text.
Position
• Supine, aligned and centered to CR and IR, both legs extended and equally rotated internally 15°-20° (see warning above)
• Ensure no rotation of pelvis (bilateral ASISs the same distances from tabletop). Support under knees for patient comfort.
AP Unilateral Hip*
Lateral Hip (Nontrauma)*
Warning: Do not attempt with possible fracture of hip area.
Position
• For femoral neck, flex affected knee and hip, and abduct femur 45° from vertical (places femoral neck near parallel to IR).
• For femoral head, acetabulum, and proximal femoral shaft, oblique patient 35°–45° toward affected side and abduct leg to tabletop if possible. Center hip and neck area to CR.
Lateral Hips (Nontrauma)*
Lateral Hip (Trauma Method)*
(Axiolateral Inferosuperior Projection [Danelius-Miller Method])
Position
• Supine, no rotation of pelvis
• Flex unaffected knee and hip and provide support such as the x-ray tube (use pad or towels for possible hot collimator).
• Rotate affected leg internally 15° unless possible hip fracture.
• Place vertical grid IR against side just superior to iliac crest with plane of IR perpendicular to CR.
AP Pelvis*
To include proximal femora, pelvic girdle, sacrum, and coccyx
Warning: Do not attempt to rotate legs if fractures involving hips are suspected.
Note: For bilateral hips centering, see p. 291.
Position
• Supine, pelvis centered to centerline, legs extended
• Both feet, knees, and legs equally rotated internally 15° (secure with tape if necessary). Support under knees for comfort.
• Ensure no rotation of pelvis (ASISs equal distance from TT).
• Center IR to CR. (Include entire pelvis.) Shield gonads (if it doesn’t compromise study).
AP Pelvis
AP Axial Pelvis*
AP Axial Pelvis
Acetabulum—Posterior Oblique Pelvis*
Note: Both sides generally are taken for comparison, either both for upside or both for downside.
• 24 × 30 cm L.W. (10 × 12″) or 35 × 43 cm C.W. (14 × 17″) if both hips must be seen on each projection.
Acetabulum*
Pediatric AP and Lateral Hips*
Position (AP and Lateral)
• Supine, pelvis centered to CR and to IR; use gonadal shields on both male and female. (Use ovarian shield of appropriate size for female, ensuring that it does not cover hip areas.)
• Immobilize arms and upper body with sandbags, tape, or compression band as needed.
*Bontrager Textbook, 8th ed, p. 274.
*Bontrager Textbook, 8th ed, p. 276.
*Bontrager Textbook, 8th ed, p. 275.
*Bontrager Textbook, 8th ed, p. 277.
*Bontrager Textbook, 8th ed, p. 283.
*Bontrager Textbook, 8th ed, p. 285.
*Bontrager Textbook, 8th ed, p. 278.
*Bontrager Textbook, 8th ed, p. 284.
*Bontrager Textbook, 8th ed, p. 277.
*Bontrager Textbook, 8th ed, pp. 279 and 280.
*Bontrager Textbook, 8th ed, p. 281.