Radiology: Hip Projection Techniques

Questions and Answers

In the Hsieh Method PA oblique projection, what angle should the patient’s body be elevated?

50 to 55 degrees

60 to 65 degrees

30 to 35 degrees

40 to 45 degrees (correct)

What is the recommended positioning for the Friedman's Method axiolateral projection?

Standing with weight evenly distributed on both legs

Lateral recumbent with the affected limb in true lateral (correct)

Supine with the unaffected limb elevated

Semi-prone with the affected limb extended

What is the central ray (CR) orientation for the Teufel Method PA axial oblique projection?

45 degrees cephalad

Perpendicular to the table

20 degrees caudad

38 degrees from the mid-sagittal plane (correct)

What should the position of the unaffected limb be in the Friedman's Method?

Rolled 10 degrees posteriorly Signup and view all the answers

Which projection requires the femoral neck to be the region of interest (RP)?

Friedman's Method axiolateral projection Signup and view all the answers

Which projection is contraindicated for patients with an acute hip injury?

Lilienfeld Method Signup and view all the answers

What is the central ray (CR) orientation for the Hsieh Method?

Perpendicular to the image receptor Signup and view all the answers

Which structure is primarily shown in the Hsieh Method PA oblique projection?

ilium, hip joint, and proximal femur Signup and view all the answers

What is the central ray angle for the Original Cleaves Method?

25-45 degrees Signup and view all the answers

In the Danelius-Miller Method, which positioning of the unaffected leg is required?

Flexed with the foot resting on support Signup and view all the answers

What is the purpose of the Chassard-Lapine Method?

To measure the transverse or biischial diameter in pelvimetry Signup and view all the answers

What should the patient's position be for the Lauenstein Method?

Supine with affected side knee flexed and thigh drawn up Signup and view all the answers

In the Clements-Nakayama Modification, what is the angle of the central ray?

15 degrees posteriorly Signup and view all the answers

Which of the following projections requires the patient's pelvis to be elevated?

Danelius-Miller Method Signup and view all the answers

For the AP Projection of the hip, how should the foot and leg be positioned?

Medially rotated 15-20 degrees Signup and view all the answers

What is the primary goal of the Staunig Method?

To demonstrate relationship of femoral head to the acetabulum Signup and view all the answers

Which projection focuses on the acetabulum and the relationship of the femoral head to the hip joint?

Judet Method Signup and view all the answers

What defines the positioning for the Taylor Method?

Supine with a caudal angle of the CR Signup and view all the answers

What is the required patient position for the Internal Oblique in the Judet Method?

Semisupine, LPO with affected hip up Signup and view all the answers

In the Taylor Method for the AP Axial 'Outlet' Projection, what is the recommended positioning for the patient's legs?

Knee flexed slightly Signup and view all the answers

Which of the following is NOT a purpose of the Internal and External Oblique projections in the Judet Method?

Evaluating the alignment of the pelvis Signup and view all the answers

Where is the central ray directed for the External Oblique projection in the Judet Method?

At the pubic symphysis Signup and view all the answers

What angle should the MSP be from the table for the Internal Oblique position of the Judet Method?

45 degrees Signup and view all the answers

In the Judet Method, what is the significance of using the horizontal CR for the External Oblique projection?

To diagnose fractures effectively Signup and view all the answers

What is the main focus of the Rafert-Long Modification of the Judet Method?

To modify the projection technique used for acetabulum Signup and view all the answers

The positioning of the patient in the PA projection includes which of the following?

Prone with IR center to greater trochanter Signup and view all the answers

Study Notes

Hip Imaging Techniques

Unilateral Projection
- Patient Position (PP): Supine, affected hip and knee flexed, feet drawn up, soles against opposite knee, thigh abducted 45° laterally.
- Radiographic Parameters (RP): 1 inch superior to femoral neck.
- Central Ray (CR): Perpendicular (┴) to the image receptor (IR).
- Structures Shown (SS): Acetabulum, femoral head, femoral neck, and trochanteric areas.
Original Cleaves Method (Axiolateral Projection)
- PP: Same as Modified Cleaves.
- RP: 1 inch superior to pubic symphysis.
- CR: Angled 25-45° for better visualization.
- SS: Acetabulum, femoral head, femoral neck, and trochanteric areas.
AP Projection
- PP: Supine, ASISs equidistant from the table, foot and leg rotated medially 15-20° to align femoral neck parallel to IR.
- RP: Focused on the femoral neck.
- CR: Perpendicular (┴).
- SS: Hip joint.
Lauenstein & Hickey Methods (Lateral Projection)
- PP: Supine, rotated toward the affected side, knee flexed, opposite leg extended.
- RP: Hip joint.
- CR: Perpendicular for Lauenstein; 20-25° cephalad for Hickey.
- SS: Visualization of hip joint with varying degrees of superimposition on femoral neck.
Danelius-Miller Method (Axiolateral Projection)
- PP: Supine, pelvis elevated, knee and hip of unaffected side flexed, IR vertical.
- RP: Femoral neck, aligned with IR.
- CR: Horizontal.
- SS: Hip joint, acetabulum, femoral head and neck, and trochanters.
Clements-Nakayama Modification (Modified Axiolateral Projection)
- PP: Supine, limb in neutral or slightly rotated position, IR top tilted 15°.
- RP: Femoral neck.
- CR: 15° posteriorly directed.
- SS: Lateral hip structures.
Chassard-Lapine Method (Axial Projection)
- PP: Seated, torso leaning forward; posterior knee against table edge; pelvis tilted 45°.
- RP: Lumbosacral region, at greater trochanter level.
- CR: Perpendicular to symphysis pubis.
- SS: Relationships between femoral heads and acetabulum; pelvic structure imaging.
Leonard-George Method
- PP: Supine with pelvis elevated; knee and hip on unaffected side flexed and thigh abducted.
- RP: Depression superior to greater trochanter.
- CR: Directed medially and inferiorly, perpendicular.
- SS: Femoral head and neck, trochanteric area.
Friedman Method (Axiolateral Projection)
- PP: Lateral recumbent on affected side, maintaining true lateral position.
- RP: Femoral neck.
- CR: 35° cephalad.
- SS: Femoral head, neck, trochanteric area, and proximal femoral shaft.

Specialized Projections

PA Oblique Projection (Hsieh Method)
- PP: Semi-prone, elevating unaffected side by 40-45°.
- CR: Perpendicular.
- SS: PA oblique of ilium, hip joint, and proximal femur.
Mediolateral Oblique Projection (Lilienfeld Method)
- PP: Lateral recumbent on the affected side.
- CR: Perpendicular to the midpoint of the joint.
- SS: Mediolateral projection of ilium, acetabulum, and proximal femur.

Acetabulum Imaging

Teufel Method (PA Axial Oblique Projection)
- PP: Semiprone, RAO/LAO; unaffected side elevated, pelvis tilted 38° from table.
- RP: Acetabulum or inferior coccyx level.
- CR: 12° cephalad.
Judet Method (AP Oblique Projection)
- PP: Internal Oblique (affected hip up) and External Oblique (affected hip down), 45° angle from the table.
- RP: 2 inches inferior to ASIS for Internal; pubic symphysis for External.
- CR: Perpendicular.
- SS: Acetabular rim, useful for diagnosing fractures.
Taylor Method (AP Axial Outlet Projection)
- PP: Supine, ASISs equidistant from table, slightly flexed knees.
- RP: 2 inches above the pubic symphysis aimed at the pelvic outlet.
- CR: Angled for optimal visualization of the pelvic outlet.

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Description

This quiz covers techniques for unilateral hip projections in radiology. It focuses on positioning, central ray placement, and structures of interest, including the acetabulum and femoral head. Perfect for students and professionals in medical imaging.