Pelvic Radiography Techniques and Errors
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Questions and Answers

What modification should be made for a repeat exposure if an AP axial (Taylor method) radiograph shows foreshortened anterior pelvic bones?

  • Increase central ray angle
  • Center central ray at level of ASIS
  • Place patient prone on table
  • Reverse central ray angle (correct)

What is the specific positioning error when an AP pelvic radiograph demonstrates a narrowed left obturator foramen?

  • Excessive tilt to the right side
  • More rotation towards the left side (correct)
  • Patient not properly centered
  • Incorrect SID used

Which of the following bones is not part of the pelvis?

  • Left hip
  • Femur (correct)
  • Right hip
  • Sacrum

What additional projection(s) can be taken to further assess pelvic fractures after an AP pelvis projection?

<p>Posterior oblique and Judet method (D)</p> Signup and view all the answers

Which of these is one of the divisions of the hip bone?

<p>Ilium (C)</p> Signup and view all the answers

What modifications are needed during the repeat exposure if a PA axial oblique (Teufel method) radiograph shows acetabulum distortion?

<p>12° cephalic rotation (C)</p> Signup and view all the answers

What name is given to one half of the pelvic girdle?

<p>Innominate bone (C)</p> Signup and view all the answers

If the central ray for an AP axial (Taylor method) radiograph is angled 30° caudad, what should be the positioning factor if the anterior pelvic bones are foreshortened?

<p>Reduce angle of central ray (C)</p> Signup and view all the answers

Which of the following landmarks is a palpable bony landmark?

<p>Greater trochanter (B)</p> Signup and view all the answers

What is the name of the imaginary plane that separates the true pelvis from the false pelvis?

<p>Pelvic brim (A)</p> Signup and view all the answers

What type of angle is the pubic arch angle on an average male pelvis?

<p>Acute angle (C)</p> Signup and view all the answers

Which structure is labeled as the femoral neck in the radiographs?

<p>Femoral Neck (C)</p> Signup and view all the answers

What is shown in Fig. 7.8?

<p>Left Femur (A)</p> Signup and view all the answers

Which projection is indicated in Fig. 7.9?

<p>Bilateral Hip (D)</p> Signup and view all the answers

Which of the following structures represents the greater trochanter?

<p>Greater Trochanter (A)</p> Signup and view all the answers

Which characteristic indicates a male pelvis?

<p>Heart-shaped (oval) inlet (D)</p> Signup and view all the answers

Which structure is considered the most posterior in relation to the pelvis?

<p>Ischial spines (A)</p> Signup and view all the answers

What is the term for the small depression near the center of the femoral head?

<p>Fovea capitis (A)</p> Signup and view all the answers

Which of the following joints has amphiarthrodial mobility?

<p>SI joints (B)</p> Signup and view all the answers

Which device is used to equalize density in an axiolateral hip projection?

<p>Boomerang compensating filter (A)</p> Signup and view all the answers

What modality is used to assess joint stability during lower limb movement in infants?

<p>Sonography (B)</p> Signup and view all the answers

A geriatric patient with an externally rotated lower limb may have which condition?

<p>A fractured proximal femur (C)</p> Signup and view all the answers

What pathologic indication may lead to early fusion of the SI joints?

<p>Ankylosing spondylitis (C)</p> Signup and view all the answers

What is the appropriate CR angle for the Judet method?

<p>None. CR is perpendicular (C)</p> Signup and view all the answers

Which projection should be used to evaluate the pelvic inlet for possible fracture?

<p>AP axial projection (A)</p> Signup and view all the answers

What action should be taken if a unilateral frog-leg projection demonstrates foreshortening of the femoral necks?

<p>Abduct femur 20-30° from vertical (B)</p> Signup and view all the answers

In a radiograph of an AP hip, if the lesser trochanter is not visible, is it necessary to repeat the exposure?

<p>No, it is acceptable based on anatomy (B)</p> Signup and view all the answers

What is the primary use of the modified axiolateral projection?

<p>To provide a view of the nontraumatic lateral hip (D)</p> Signup and view all the answers

Which projection(s) are most commonly performed for a young patient with SCFE?

<p>AP Pelvis, bilateral modified (B)</p> Signup and view all the answers

What likely artifact might obscure the femur in an axiolateral projection of a hip?

<p>False leg higher (B)</p> Signup and view all the answers

Which method is designed specifically for imaging in patients with suspected hip joint pathologies?

<p>Danelius-Miller method (D)</p> Signup and view all the answers

Which radiographic appearance consists of numerous small lytic lesions?

<p>Hallmark sign of spurring and narrowing of joint space (C)</p> Signup and view all the answers

What indicates that the proximal femurs are positioned correctly for a true AP projection?

<p>Appearance of the greater trochanter in profile (D)</p> Signup and view all the answers

What is another term for the outlet of the true pelvis?

<p>Inferior aperture (A)</p> Signup and view all the answers

What is a typical physical sign for a possible hip fracture?

<p>External rotation (C)</p> Signup and view all the answers

Which projection is often performed to evaluate pediatric patients for congenital hip dislocation?

<p>Bilateral modified Cleaves method (C)</p> Signup and view all the answers

What type of central ray angle is required for the AP axial outlet projection for a male patient?

<p>10° to 15° cephalad (D)</p> Signup and view all the answers

How much is the pelvis rotated for a PA axial oblique projection (Teufel method) for acetabulum?

<p>35° to 40° toward affected side (D)</p> Signup and view all the answers

What type of CR angle is required for the PA axial oblique (Teufel method) for acetabulum?

<p>20° caudad (D)</p> Signup and view all the answers

Flashcards

Modified Axiolateral (Clements-Nakayama) Projection

A projection used to evaluate the hip joint from the side, specifically for nontraumatic situations.

Judet Method

A projection that requires a specific 12° cephalad CR angle, focusing on the affected hip.

AP Axial Projection

A projection primarily used for evaluating a potential fracture in the pelvic inlet.

Bilateral Modified Frog-Leg Projection

A projection commonly used in evaluating a patient with a suspected Slipped Capital Femoral Epiphysis (SCFE).

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Danelius-Miller Method

A projection that evaluates the hip joint from the side, particularly for hip fractures.

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AP Hip Projection

A projection that evaluates the hip joint from the front, used for various hip situations.

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AP Pelvis Projection

A projection that focuses on the pelvis as a whole, primarily in cases of suspected pelvic fractures.

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Unilateral Frog-Leg (Modified Cleaves) Projection

A projection used to evaluate the hip joint from the side in a more general setting, particularly for nontraumatic situations.

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Multiple Myeloma Radiographic Appearance

A radiographic appearance characterized by numerous small lytic lesions, often associated with multiple myeloma.

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Legg-Calvé-Perthes Radiographic Appearance

A radiographic appearance showing increased hip joint space and misalignment, often associated with conditions like Legg-Calvé-Perthes disease.

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Ankylosing Spondylitis Radiographic Appearance

A radiographic appearance exhibiting bilateral radiolucent lines across bones and misalignment of the sacroiliac joints, typically indicative of ankylosing spondylitis.

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True AP Projection of Proximal Femur

A radiographic sign indicating that the proximal femurs are positioned correctly for a true anterior-posterior projection.

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Outlet of True Pelvis

Another term for the outlet of the true pelvis, which is the inferior opening of the pelvic cavity.

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Typical Physical Sign of Hip Fracture

The typical physical sign of a possible hip fracture, characterized by an outward turn of the affected leg.

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Evaluation of Congenital Hip Dislocation (Pediatric)

A radiographic method often used to evaluate congenital hip dislocation in pediatric patients, involving taking images from both sides of the hip.

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PA Axial Oblique (Teufel Method)

A radiographic projection used to evaluate the acetabulum, requiring a specific angle of rotation of the pelvis and a cephalad tilt of the central ray.

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What modality assesses infant hip stability?

Imaging modality typically used to assess joint stability of infants, especially during lower limb movements.

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What is the purpose of a 15° caudal angle for a hip projection?

A specific radiographic projection of the hip where the central ray is angled 15 degrees caudally, providing an axiolateral view.

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Describe the female pubic arch.

Radiographic characteristic of a female pelvis, marked by a wider pubic arch with an angle greater than 90 degrees.

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What is the fovea capitis?

A small pit on the top of the femoral head where ligaments attach.

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What is ankylosing spondylitis?

A medical condition leading to early fusion of the sacroiliac joints, potentially causing stiffness and pain.

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Describe the Judet method projection.

A projection that involves a 12° cephalad angle, specifically tailored for examining the affected hip.

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What is a modified frog-leg projection?

A projection technique where the patient's hip is rotated outward.

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How are the iliac wing shapes different in males and females?

Radiographic characteristic of a male pelvis where the iliac wings are more flared, offering a wider shape.

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Taylor Method: Foreshortening

The anterior pelvic bones are foreshortened when the central ray is angled too caudad, reducing the beam's angle.

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Pelvis Rotation: Obturator Foramen

When the pelvis is rotated, the obturator foramen on the side rotated towards appears smaller, while the opposite side appears larger.

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Pelvic Ring Fracture: Additional Projections

To assess pelvic ring fractures, additional projections like the posterior oblique and Judet method are taken to provide different angles for better visualization of the pelvic ring.

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Teufel Method: Acetabulum Distortion

In the Teufel method, too much cephalad angulation can distort the acetabulum. Repositioning is needed with a smaller cephalad angle.

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Judet Method: Specific Views

The Judet method is a specific set of projections that provides detailed views of the hip joint, particularly after a hip fracture or the acetabulum.

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What are the three components of the hip bone?

The hip bone is part of the pelvic girdle and is comprised of three fused bones: the ilium, ischium, and pubis. It's often referred to as the innominate bone, meaning 'nameless'.

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What is the pelvic brim and what does it separate?

The pelvic brim is an imaginary line that separates the greater pelvis (false pelvis) from the lesser pelvis (true pelvis). It plays a crucial role in childbirth as the true pelvis defines the birth canal.

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Describe the pelvic girdle.

The pelvic girdle is formed by the two hip bones (innominate bones) and the sacrum. It serves as the foundation for connecting the lower limbs to the axial skeleton and plays a vital role in weight distribution in humans.

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What is the largest foramen in the body and where is it located?

The obturator foramen is the largest foramen in the human body. It is located between the ischium and pubis bones and allows passage for nerves and blood vessels.

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Identify four palpable bony landmarks on the hip.

The greater trochanter, lesser trochanter, ischial tuberosity, and ASIS (anterior superior iliac spine) are all bony landmarks that can be easily felt on the hip. These landmarks are crucial for various procedures and medical assessments.

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Pubic Arch Angle in Males

The angle formed by the two pubic bones at their junction. In males, it is typically less than 90 degrees, creating a more acute angle.

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Lateral Hip Radiograph

A radiographic projection that captures the hip joint from the side. It's useful for viewing the femoral neck and head in detail.

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Bilateral Hip Radiograph

A radiographic projection that shows both hip joints simultaneously, allowing for comparison of both sides.

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Greater Trochanter

The bony prominence on the femur that marks the attachment point for muscles like the gluteus medius and minimus. It can be seen in both anteroposterior and lateral hip projections, but its prominence can vary depending on the angle of the image.

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Femoral Neck

The narrow, constricted portion of the femur that connects the femoral head to the femoral shaft. It's a common site for fractures.

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Study Notes

Radiographic Characteristics of Male/Female Pelvis

  • Heart-shaped (oval) inlet: Male pelvis
  • Acute pubic arch (less than 90°): Male pelvis
  • Iliac wings that are more flared and rounded in: Male pelvis
  • Obtuse pubic arch (greater than 90°): Female pelvis

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Description

Test your knowledge of pelvic radiography techniques and common positioning errors. This quiz covers key concepts such as the AP axial (Taylor method), PA axial oblique (Teufel method), and anatomy related to the pelvic girdle. Assess your understanding of the projections and modifications needed for accurate imaging.

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