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Hip X-ray views

Frog Leg Lateral View Cross Table Lateral Hip Pelvis AP


Patient position

● The knee joint is flexed 30° – 40° in a ● Affected side: lower extremity is rotated 15° - ● The image is taken toward the middle of
supine position while hip is externally 20° in a supine position the line connecting the upper part of the
rotated by 45° ● Hip & Knee joints on the other side are flexed symphysis pubis and the ASIS
● The image is taken toward the middle line to prevent interference in radiographic
connecting the upper symphysis pubica and projection ● Both patellae should be facing forward or
the anterior-superior iliac spine ● Cassette is positioned on the side of the hip lower extremities should be internally
at the right angle relative to the incidence rotated by 15° -20° to accommodate
angle femoral anteversion in anteroposterior hip
● Projection is toward the groin region at 35° - radiographs
45° of incidence parallel to the longitudinal
axis of the femur
Radiographic Image

• Provides information on proximal femoral • Provides information on proximal femoral • Provides information on the shape of the
PURPOSE

parts including the femoral head parts including the femoral head acetabulum
• Specific info: leg length, neck-shaft angle,
acetabular coverage, acetabular depth,
acetabular inclination, acetabular version,
head sphericity & joint space width
Advantages: Advantages: Standard AP Hip Radiograph (Fig 6)
• Can be taken multiple times in a similar • The greater trochanter is positioned • The coccyx & symphysis pubis are in a
position posteriorly so that the femoral head junction straight line & are positioned in the middle
• Makes it easy to evaluated the: sphericity is well defined line of the image
of the femoral head, joint congruency and • Both sides of the iliac wings & obturator
the shape and offset of the neck junction Disadvantages: foramina are symmetric
• Bony landmarks may not be clear in obese • The distance between the superior border
Disadvantages: patients of the pubic symphysis & the coccyx is
• Head-neck junction is often not clearly between 1-3cm
visible beceause it is obscured by the • Greater & Lesser trochanters should be
greater trochanter clearly distinguishable
• Rarely used to diagnose fractures • Calcar femoris should be clearly visible
Notes

• There should be very little elliptical overlap


Session Notes: between the anterior & posterior margins
• Usually requested for children of the head-neck junction.

MOST COMMON ERROR in taking AP view:


• Hip is externally rotated while the image is
being taken
• In this case, the greater trochanter
overlaps with the femoral head
• the posterior head-neck junction is
projected to the superior to the anterior
head-neck junction
• In short the is IMAGE DISTORTION
Lim, S. & Park, Y. (2015). Plain radiography of the hip: a review of radiographic techniques and image features. Hip & Pelvis 27(3): 125-134.

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