Menu Search Donate
Guideline identity image

Plain Films - Pelvis and Hip

This document is only valid for the day on which it is accessed. Please read our disclaimer.

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 forward.
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 

Did you find this information helpful?

Document Control

  • Date last published: 26 December 2017
  • Document type: Imaging Protocol
  • Services responsible: Paediatric Radiology

More From Starship

  • Paediatric Imaging

    Visit the Alliance for Radiation Safety in Paediatric Imaging to learn about the 'image gently' campaign