S2. Procedures Final pdf

• Prominent structures of the proximal femur

  • Femoral head
  • Femoral neck
  • Greater trochanter
  • Lesser trochanter
• Prominent structures of the distal femur

  • Medial and lateral femoral condyles
  • Intercondylar fossa
  • Intercondylar sulcus (patellar groove)
• Positioning the lower limb to demonstrate the femoral neck without distortion or superimposition

  Rotate internally 15-20 degrees
• Alignment of IR for proximal femur projections

  Top of the IR at the ASIS
• Alignment of IR for distal femur projections


  Bottom of the IR 2" below the knee
• Assessing rotation in a distal lateral femur

  Anterior surface of femoral condyles superimposed
• The inferior surfaces of the femoral condyles will not be superimposed when performing a lateral distal femur because the medial condyle is 5-7 degrees longer than the lateral (not angling tube to compensate as with the knee)
• Parts of the pelvis

  • Ilium
  • Ischium
  • Pubis
• The average adult femoral neck projects anteriorly from the body 15-20 degrees
• Type of joint the hip joint is

  Synovial, ball and socket
• Type of joint the pubic symphysis is

  Cartilaginous, amphiarthrodial
• Characteristic differences between male and female pelvis

  • SHAPE: female = wide/shallow, male = narrow, deep
  • BONY STRUCTURE: female = light, male = heavy
  • INLET: female = oval, male = round
  • OUTLET: female = wide, male = narrow
• Palpable bony landmarks located in the pelvis and hip region

  • Iliac crest
  • ASIS
  • Pubic symphysis
  • Greater trochanter
  • Ischial tuberosity
  • Tip of coccyx
• Landmarks used for hip joint localization

  • ASIS
  • Pubic symphysis
• Proper distance for heels apart to internally rotate lower limbs for AP pelvis

  1. 10 inches
• CR direction for an AP projection of the pelvis

  2" inferior to ASIS and 2' superior to pubic symphysis (midway between)
• IR positioning for an AP projection of the pelvis

  Top of the IR above the iliac crest
• Assessing rotation on an AP projection of the pelvis

  Symmetry of ala, symmetry of obturator foramen, vertebral column centered, femoral necks seen in full extent, ischial spines equally seen, sacrum and coccyx aligned with pubic symphysis
• Localization method for CR placement of an AP projection of the hip joint

  CR placed approximately 1.5 inches (femoral head) or 2.5 inches (femoral neck) distal on a line drawn perpendicular to the midpoint between the ASIS and pubic symphysis; OR 1-2" medial to ASIS, 3-4" distal (femoral neck)
• IR alignment for an axiolateral projection of the hip

  Parallel to femoral neck
• CR alignment for an axiolateral projection of the hip

  Perpendicular to femoral neck
• Lower limb positioning for an axiolateral projection of the hip

  Affected leg extended and internally rotated, unaffected leg hip and knee flexed above affected leg
• Proper name of the axiolateral projection of the hip

  Danelius-Miller method
• Where contrast is injected during arthrography

  Into the joint capsule
• Joints that can be imaged using arthrography

  • Shoulder
  • Knee
  • Hip
  • ANY synovial joint
• Type of contrast used during arthrography

  Water-soluble, air
• Primary purpose of imaging a specific joint with contrast

  Visualize soft tissue structures/injuries
• Avascular necrosis


  Death of bone tissue due to lack of blood supply
• The most common fracture site of the hip in elderly patients is the intertrochanteric line/crest
• Functions of the vertebral column

  • Encloses and protects spinal cord
  • Supports trunk and skull
  • Provides muscle attachments
• There are 33 vertebrae present at birth
• There are 24 adult vertebrae that are true, moveable
• Curvature of the cervical spine

  Lordotic curve; convex anteriorly; concave posteriorly
• Composition of the center of the vertebral disk

  Nucleus polposus – central, soft mass
• Unique features specific to cervical vertebrae

  • Transverse foramina
  • Bifid spinous processes
• Portion of C1 that receives the condyles of the occipital bone

  Super articular processes
• Assessing rotation on an AP projection of the cervical spine

  Spinous processes equidistant to pedicles, aligned midline of cervical bodies
• Structures visualized in AP axial oblique projections of the cervical spine

  Intervertebral foramina and pedicles farthest from IR
• IR alignment for a lateral projection of the cervical spine

  Top of the IR about 1 inch above EAM
• Projection that demonstrates the zygapophyseal joint of C1-C2

  AP open mouth