Plain Films - Pelvis and Hip
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|Injury? SUFE or painful hip||AP Pelvis and Frog Lateral of both hips. If frog not possible, coned lat of both hips|
|Perthes Protocol (only if specifically requested)||1. AP Pelvis with legs in neutral position
2. Frog Lateral
3. AP Pelvis with hips in maximum abduction
4. First Exam only L wrist & hand for bone age
|CDH/DDH or clicky hips||AP hips only including the iliac crest.
Ensure pelvis is in a perfectly straight AP position.
Have parents hold baby's legs slightly internally rotated (need both hands) use sandbags for arms if necessary.
Use non bucky and no gonad shielding on initial films.
|Van Rosen view||AP Pelvis, legs in 45% abduction, internal rotation|
|Judet views||These are 45deg views of hip to demonstrate the anterior and
posterior pillars of the acetabulum.
CT is often a more valuable option (3D recons)
Pain relief is usually required (for the patient).
Three views of the side or sides should be obtained:
1. Straight AP Centred to the femoral head
2. 45 deg oblique with affected side raised, centre to femoral head
3. 45 deg oblique with patient rolled onto affected side. Centre to femoral head
May need both sides for comparison
|Billings view||Similar to frog Lateral. Femur supported on special Billings wooden blocks (R2 cupboard)|
|False Profile view of Acetabulum||Patient standing lateral to upright bucky, feet facing
Have patient step back to 65 Deg oblique, keeping foot closest to bucky in the Lat position (ballet pos #3).
Centre on hip closest to bucky. Cone to hip
This view shows the extent of anterior coverage of the femoral head
Done only on specific request
|Gonad Shielding||Gonad shielding is not to be used on any new
cases, or follow ups under one year old.
Gonad shielding is to be used on all follow ups over one year old UNLESS patient is so uncooperative that shielding might move.
OR parent /caregiver requires shielding to be used on initial films, do this carefully and note on request
DO NOT allow patient to place the shielding - they often have no idea where their testicles really are - do it yourself. Careful placement and taping of gonad shielding will save a lot of repeats
Boys - pointy end up
Girls - pointy end down
Ensure you use the appropriate size. Use tape to secure the lead
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- Date last published: 26 December 2017
- Document type: Imaging Protocol
- Services responsible: Paediatric Radiology
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