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AP View of Pelvis

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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