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Pelvic Radiology

The document discusses techniques and technical considerations for various pelvic radiograph views including the pelvic inlet, pelvic outlet, obturator oblique, iliac oblique, and frog leg views. For each view, it provides details on patient positioning, centering points, and anatomy that should be visualized in the image. The goal is to properly demonstrate bony pelvic anatomy while avoiding superimposition of structures.

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Gayle Grey
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268 views30 pages

Pelvic Radiology

The document discusses techniques and technical considerations for various pelvic radiograph views including the pelvic inlet, pelvic outlet, obturator oblique, iliac oblique, and frog leg views. For each view, it provides details on patient positioning, centering points, and anatomy that should be visualized in the image. The goal is to properly demonstrate bony pelvic anatomy while avoiding superimposition of structures.

Uploaded by

Gayle Grey
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Gayle Krystle A. Grey, M.D.

 1. Three Rings
 2. Joint Spaces
 3. Acetabulum
 4. Sacral Foramina
 5. Proximal Femur

Murphy, A. & Jones, J. Pelvic Radiograph: An Approach. Radiopedia Org., accessed online 2019
 1. Three Rings
 2. Joint Spaces
 3. Acetabulum
 4. Sacral Foramina
 5. Proximal Femur

Murphy, A. & Jones, J. Pelvic Radiograph: An Approach. Radiopedia Org., accessed online 2019
 1. Three Rings
 2. Joint Spaces
 3. Acetabulum
 4. Sacral Foramina
 5. Proximal Femur

Murphy, A. & Jones, J. Pelvic Radiograph: An Approach. Radiopedia Org., 2019


 1. Three Rings
 2. Joint Spaces
 3. Acetabulum
 4. Sacral Foramina
 5. Proximal Femur

Murphy, A. & Jones, J. Pelvic Radiograph: An Approach. Radiopedia Org., accessed online 2019
 1. Three Rings
 2. Joint Spaces
 3. Acetabulum
 4. Sacral Foramina
 5. Proximal Femur

Murphy, A. & Jones, J. Pelvic Radiograph: An Approach. Radiopedia Org., accessed online 2019
 1. Three Rings
 2. Joint Spaces
 3. Acetabulum
 4. Sacral Foramina
 5. Proximal Femur

Murphy, A. & Jones, J. Pelvic Radiograph: An Approach. Radiopedia Org., accessed online 2019
 Technique
 Patient is supine
 Lower limbs are internally rotated 15-25° from the hip

 Technicalities
 Entirety of the bony pelvis is imaged from superior of the iliac crest to the proximal shaft
of the femur
 Obturator foramina appear equal
 Iliac wings have an equal concavity
 Greater trochanters of the proximal femur are in profile

Young JW, Burgess AR, Brumback RJ et-al. Pelvic fractures: value of plain radiography in early
assessment and management. Radiology. 1986;160 (2): 445-51
 Technique
 Patient is supine
 Lower limbs are internally rotated 15-25° from the hip
 Centering point is midline at the level of the anterior superior iliac spine
 The central ray is angled 25-40° caudal to be perpendicular to the plane of the pelvic
inlet

 Technicalities
 The entirety of the bony pelvic rim is central to the image without superimposition
 The iliac wings are evident on the superior portion of the image, the inferior and superior
pubic rami are superimposed on the inferior portion.

Ricci WM, Mamczak C, Tynan M et-al. Pelvic inlet and outlet radiographs redefined. J Bone Joint Surg
Am. 2010;92 (10): 1947-53.
 Technique
 Patient is supine
 Lower limbs are internally rotated 15-25° from the hip
 The central ray is angled 20-35° cephalic for males and 30-45° for females (see figures 2 and
3)

 Technicalities
 The entirety of the bony pelvis is imaged from superior of the iliac crest to the proximal
shaft of the femur.
 The pubic symphysis should be central to the image with little to no patient rotation.
 There is a clear demonstration of both the anterior and inferior pubic ramus with little to no
foreshortening
 Technique
 Patient is supine.
 The affected side is rotated roughly 45° anterior, generally aided by a 45° sponge
 Ensure the patient is central on the table and at no risk of over rolling
 Centering point is 5 cm distal and 5 cm medial of the ASIS that is rolled up anterior to the
image receptor

 Technicalities
 The obturator oblique projection should distinctly show the posterior rim as well as the
anterior ilioischial line. ‘
 As per the name, the obturator foramen is well demonstrated.
 Technique
 Patient is supine
 The unaffected side is rotated roughly 45° anterior, generally aided by a 45° sponge
 It is advisable that the patient is positioned central on the table and at no risk of over-
rolling
 Centering point is 5 cm distal and 5 cm medial of the ASIS closest to the image receptor

 Technicalities
 The iliac oblique projection should demonstrate the anterior rim of the acetabulum as
well as the posterior ilioischial column.
 The iliac wing, as it is 'flattened' out on the image, should be well demonstrated.
 Technique
 Patient is supine with both arms on the chest, the side in question closest to the image
receptor:
 The image receptor is angled approximately 20-45° to match the angle of the neck of
femur (observed on the AP pelvis/ hip) (parallel to the position of the femur)
 before progressing to shooting, the patient's unaffected hip is flexed and abducted

 Technicalities
 The lesser trochanter can be seen in profile, while the proximal femoral shaft
superimposes the greater trochanter.
 There is a clear visualization of the articular surface of the acetabulum and the head
of the proximal femur.
 The opposite leg has been elevated enough that there is no obstructing soft tissue
artefact.

Young JW, Burgess AR, Brumback RJ et-al. Pelvic fractures: value of plain radiography in early assessment and management. Radiology. 1986;160 (2): 445-51

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