4/14/2024 0 Comments Normal xray of the hipThe patient will be in a significant amount of pain, explain what you are about to do before you start the exam and why you are doing it, maintain the patient's decency and ensure they are comfortable as possible.Developmental dysplasia of the hip (DDH) is a relatively common disorder in newborns, with a reported prevalence of 1– births. Any movement of the patient should be done via movement of the trolley and/or mattress. Tight collimation is important in this examination as it reduces scatter and improves subject detail.ĭo not attempt to move the affected leg to position the patient better, the advantage of using this projection is the lack of movement involved. It is imperative to set the room up before positioning the patient, following the patient positioning steps above sequentially will minimise patient discomfort and maximise the quality of the exam.Īlthough 18 x 24 cm collimation seems ambitious, it is readily achievable with correct centring and well thought out positioning. Ensure the edge of the image receptor is superior to the iliac crest to ensure anatomy inclusion. When performing this technique, it is more common to err on positioning the image receptor too distally, hence missing the hip joint completely. The opposite leg has been elevated enough that there is no obstructing soft tissue artefact.Īn oblique lateral hip is helpful for visualisation of the articular surfaces of the femoral head, yet it foreshortens the neck and can result in misdiagnosis 3. There is a clear visualisation of the articular surface of the acetabulum and the head of the proximal femur. The femoral neck is central to the image and shows no signs of radiographic foreshortening or elongation. ![]() The lesser trochanter can be seen in profile, while the proximal femoral shaft superimposes the greater trochanter. If the distal femur is overexposed, a filter may be required. The radiograph has a uniform exposure throughout, evident by the fine bony detail and no areas of overexposure. patients that lack bone density require a compensating filter over the inferior aspect of the femur to allow even distribution of exposure, whilst patients with increased adipose tissue may not need a filter as the adipose tissue does a sufficient amount.a grid can be used, although it is not uncommon to utilise an air gap technique to achieve similar results.inferosuperior 12 cm each direction from the centring point.anteroposterior 9 cm each direction from the midline.the technical centring point is 13 cm distal to the neck of femur, anecdotally known as centring at the most superior region of the groin.the central ray is angled perpendicular to the long axis of the neck of femur the image receptor should be adjusted to match this angle.axiolateral (inferosuperior) projection.the flexed leg is placed on a dedicated stand this is incredibly uncomfortable for the patient the leg should only be up for a limited amount of time.the patient's unaffected hip can now be flexed and abducted.elevate the bed/trolley until the central ray is at the level of mid-thigh of the unaffected leg. ![]() This will ensure adequate centring in the superior-inferior aspect of the projection
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