The AP of the whole pelvis (not shown on the X-rays on this page) should be fully assessed because pelvic fractures can mimic the clinical features of a hip fracture. Standard viewsĪP (Anterior-Posterior) pelvis and Lateral hip. Also allows for evaluation of integrity of pelvic ring and shape of acetabulum Uses. The ilioischial line starts from the iliac wing medial margin and extends to. It delineates the pelvic anterior column. The iliopectineal line extends from the iliac wing medial margin, along the superior margin of the superior pubic ramus, to the pubic symphysis. Allows for evaluation of symmetry bilaterally. Numerous lines, arcs and stripes make up the pelvic radiograph (Figs. Particular care is needed in assessing the X-ray when physical examination is limited, for example if a patient is acutely confused. Standing or supine, with bilateral lower extremities internally rotated 15-25 at the hip to accommodate for femoral anteversion, allowing for better visualization of the femoral neck Advantage. Repeat X-rays, CT or MRI may be required if pain persists. In this case the X-ray may not show an obvious fracture. Contemporary Diagnostic Radiology (ISSN 0149-9009) is published bi-weekly by Lippincott Williams & Wilkins, Inc., 16522 Hunters Green Parkway, Hagerstown, MD 21740-2116. A sound understanding of the standard radiographic techniques, normal anatomy, and patterns of disease affecting the pelvis can be helpful in accurate diagno. It is important to be aware that the common clinical signs of a shortened and externally rotated leg may be absent if the fracture is not displaced. Campbell, M.D., Clinical Professor of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. Many hip fractures are clinically and radiologically obvious. Remember to assess the surrounding pelvic bonesįractures of the proximal femur or 'hip' are a common clinical occurrence in elderly, osteoporotic patients.Particular caution is required in the case of acutely confused patients.Not all hip fractures are visible on the initial X-ray and follow-up imaging may be required if concern remains.

Normal female hip xray