The ongoing relevance of acetabular fracture classification. Treatment varies from Pavlik bracing to surgical reduction and osteotomies depending on the age of the patient and degree of dysplasia. Hutt JR, Ortega-Briones A, Daurka JS et-al. Developmental dysplasia of the hip (DDH) is a disorder of abnormal development resulting in dysplasia, subluxation, and possible dislocation of the hip secondary to capsular laxity and mechanical factors.Plain Radiography of the Hip: A Review of Radiographic Techniques and Image Features. ABC of Emergency Radiology, Third Edition. Emergency Department Evaluation and treatment of Acute Hip pain. Academic Radiology, Vol 25, No 10, October 2018. The views and needs of program directors. In a normal hip joint, the acetabular roof covers the entire femoral head (good coverage). Radiology Education in Medical School and Residency. Want a more in-depth review? Check out Taming the Sru, Startradiology, or, all of which have excellent reviews of the pelvic x-ray.ĭealing with polytrauma? Check out EMRad’s approach to the wrist, foot, elbow, shoulder, ankle, or knee. The lateral radiograph should include the acetabulum, ischial spine and tuberosity, and proximal femur.įigure 12: Judet view.The patient’s legs should be internally rotated to maximize visualization of the femur anatomy.The AP radiograph of the pelvis should include the whole pelvis, proximal 3rd of the femur, and the lumbar spinous processes, coccyx, and pubic symphysis in a straight line.Require minimal movement of the affected painful hip.For trauma: “Cross Table Lateral” or “Horizontal Beam Lateral” has these views.There are multiple ways to perform the “lateral view”.A standard “hip series” consists of the AP view of the pelvis and a lateral view of the affected extremity.
2 visits: Bring patient back for repeat filmsĪn approach to the traumatic adult hip x-ray.2 occasions: Always compare with old x-rays if available.2 sides: If unsure regarding a potential pathologic finding, compare to another side.2 joints: Image above and below the injury.2 abnormalities: If you see one abnormality, look for another.MRI hip protocols can be done in as little as 5-15 minutes.īefore we begin: Make sure to employ the rule of 2’s Consider MRI for patients with significant hip pain and negative x-rays. 2% of occult hip fractures will be missed by CT.As the cartilage wears away, it becomes frayed and rough, and. In osteoarthritis, the cartilage in the hip joint gradually wears away over time. Compared with CT, pelvic radiographs have a sensitivity of 64% to 78% for the identification of pelvic fractures in blunt trauma. Osteoarthritis is a degenerative type of arthritis that occurs most often in people 50 years of age and older, though it may occur in younger people, too.Hip fractures have a very high one-year mortality.Hip and thigh pain are common complaints in the ED.Why the hip matters and the radiology rule of 2’s The Hip Identify clinical scenarios in which an additional view might improve pathology diagnosis.Interpret traumatic hip x-rays using a standard approach.When applicable, it will provide pertinent measurements specific to management, and offer a framework for when to get an additional view, if appropriate. This is EMRad, a series aimed at providing “just in time” approaches to commonly ordered radiology studies in the emergency department.