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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

AP View of Pelvis   



- See:
      - X-rays for THR
      - X-rays for Femoral Neck Fractures

- Discussion:
    - this view should demonstrate the iliac bone, sacrum, pubis, ischium, femoral heads and necks, and greater or lesser trochanters;
    - arcuate, iliopubic, ilioischial, and acetabular teardrop lines, sacral foramina, & SI joint should be scrutinized carefully and identified in a systematic manner;
    - patient is supine with the feet slightly (15 deg) internally rotated;
    - central beam is directed vertically toward the mid-portion of pelvis;
    - for arthritic hips, may get standing films;
    - Young and Burgess state that 90 % of all traumatic injuries to the pelvic ring can be diagnosed on AP radiographs alone;

- Landmarks include:
    - iliopectineal line: denotes limit of anterior column;
    - ilioischial line: denotes limit of posterior column;
    - anterior lip of the acetabulum;
    - posterior lip of acetabulum;
    - superior wt bearing surface of acetabulum, ending in medial tear drop;

- Misc:
    - in pts w/ severe flexion contractures of hip, AP view frequently appears similar to pelvic inlet view, because pelvis is tilted inferiorly;
          - in such cases, better AP radiograph is produced if the hips are slightly flexed to place the pelvis in a more neutral position



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, September 6, 2012 2:05 pm