Ch. 7
Which of the following structures is not an aspect of the proximal femur?
Obturator foramen
Which of the following structures is considered to be most inferior or distal?
Lesser trochanter
Why must the lower limb be rotated 15
To place the femoral neck parallel to the image receptor
The term pelvic girdle refers to the total pelvis including the sacrum and coccyx.
False
Which bones fuse to form the acetabulum?
Ischium, pubis, and ilium
Which of the following bony structures cannot be palpated?
Ischial spine
Which bone of the pelvic girdle forms the anterior inferior aspect?
Pubis
The lesser sciatic notch is an aspect of the:
ischium.
The sacroiliac joints are classified as ____ joints with ____ mobility.
synovial; amphiarthrodial
The symphysis pubis provides limited movement during pelvic trauma and during:
labor and delivery.
The two bony landmarks that are palpated using the hip localization method are the:
ASIS and the symphysis pubis.
Using the hip localization method, the femoral head can be located:
1 1/2 inches (4 cm) below the midpoint of the imaginary line between the two bony landmarks.
Select the correct gender to correspond with the following pelvic characteristics. More oval or heart-shaped pelvic inlet:
Male
Select the correct gender to correspond with the following pelvic characteristics. Wider and shallow general shape of pelvis:
Female
Select the correct gender to correspond with the following pelvic characteristics. Obtuse angle of pubic arch:
Female
Select the correct gender to correspond with the following pelvic characteristics. Round and large pelvic inlet:
Female
Select the correct gender to correspond with the following pelvic characteristics. Narrower, deeper general shape of pelvis:
Male
Select the correct gender to correspond with the following pelvic characteristics. Acute angle of pubic arch:
Male
Gonadal shielding of the male patient for the AP pelvis projection requires that the top of the shield is not extend above the level of the:
inferior margin of the symphysis pubis.
A common condition of the femur that develops in elderly patients, leading to frequent fractures of the hip (proximal femur), is:
avascular necrosis
Which of the following imaging modalities can be performed on a newborn to assess hip joint stability during movement?
Sonography
Which of the following conditions will produce the radiographic sign referred to as “bamboo spine”?
Ankylosing spondylitis
Which of the following pathologic conditions often occurs in males older than the age of 45 years?
Chondrosarcoma
Which of the following pathologic conditions is a common type of aseptic or ischemic necrosis?
Legg-Calvé-Perthes disease
Which of the following conditions will produce shortening of the epiphyses but widening of the epiphyseal plate?
Slipped capital femur
The use of the 80 to 85 kV (analog) technique (as opposed to 70 kV) with a corresponding mAs change for an AP pelvis projection will result in:
reduction in gonadal dose.
Gonadal shielding should be used on both males and females of childbearing age for AP hip projections, if correctly placed.
True
Cephalopelvimetry is still commonly performed in the U.S.
b. False
Where is the CR placed for an AP projection of the pelvis?
Midway between the ASIS and the symphysis pubis
What is the amount of abduction of the femurs recommended for an AP bilateral frog-leg projection?
40
Which of the following positions will best demonstrate signs of developmental dysplasia of the hip?
Bilateral frog-leg method
Which of the following positions will best demonstrate the posterior (ilioischial) column and anterior (iliopubic) column of the pelvis?
Posterior oblique (Judet method)
Which one of the following projections will best demonstrate a lateral oblique view of the femoral head and neck for the patient with limited movement in both lower limbs?
Modified axiolateral (Clements-Nakayama)
What type of CR angle must be used for an AP axial (Taylor method) “outlet” projection for a male patient?
20
How much rotation of the body is required for posterior axial oblique projection (Teufel method)?
35
What type of CR angle is required for the posterior axial oblique projection (Teufel method)?
12
The posterior oblique (Judet method) for the acetabulum requires a 10
False
Only a small part of the lesser trochanter, if any, will be visible on a well-positioned axiolateral (inferosuperior) lateral hip.
True
The image receptor must be placed parallel to the femoral neck for the axiolateral (inferosuperior) projection of the hip.
True
Which of the following projections would be best for a patient with limited movement of both lower limbs (in addition to the AP pelvis)?
Modified axiolateral (Clements-Nakayama method)
The proper name of the method used for the unilateral frog-leg projection is the _____ method.
modified Cleaves
What CR angle is required for the AP axial, inlet projection?
40
A radiograph of an AP pelvis reveals that the lesser trochanters are not visualized. This pelvis projection was performed for nontraumatic reasons. What should the technologist do (if anything) to correct this on the repeat exposure?
Do nothing. Accept the radiograph and do not repeat the exposure.
A radiograph of an AP pelvis reveals that the right iliac wing is foreshortened as compared with the left side. What specific positioning problem is present on this radiograph?
Left rotation
A radiograph of an AP pelvis reveals that the left obturator foramen is more open or elongated as compared with the right. What is the specific positioning error present on this radiograph?
Right rotation
A radiograph of a unilateral frog-leg (modified Cleaves method) projection reveals that the femoral neck is foreshortened and distorted. The radiologist is concerned about pathology involving the neck. What can the technologist do to improve the visibility of the femoral neck without foreshortening during the repeat exposure?
Decrease the abduction of the femur to 20
A radiograph of an axiolateral (inferosuperior) projection of the hip reveals a soft tissue artifact seen across the affected hip. This artifact prevents a clear view of the femoral head and neck. What must the technologist do to eliminate this artifact or its effect during the repeat exposure?
Increase the elevation and flexion of the patient’s unaffected leg.
A PA axial oblique projection (Teufel method) is performed on a patient. The resultant radiograph demonstrates distortion of the acetabulum. The following positioning factors were used: 40° anterior oblique, 12° cephalad CR angle, and CR centered to the upside hip (acetabulum). What needs to be modified during the repeat exposure?
Center CR to downside hip (acetabulum).
A radiograph of an axiolateral (inferosuperior) projection reveals that there is an excessive amount of grid lines present. A 6:1 linear grid was used. Which of the following points will correct this problem on the repeat exposure?
Keep the image receptor parallel to the femoral neck and perpendicular to CR.
A patient enters the ER having sustained trauma to the pelvis. The patient’s main complaint is about her left hip. Which of the following projections should be taken first to rule out fracture or dislocation?
AP pelvis
A nontrauma patient comes to radiology with a history of chronic pain of the right hip. The patient is ambulatory but has not had previous radiographs taken of that hip. Which of the following routines would be best suited for this patient?
AP pelvis and axiolateral frog-leg (modified Cleaves) projections of the right hip
Generally, gonadal shielding for females cannot be used for an initial AP pelvis for pelvic trauma due to the possibility of covering pertinent anatomy.
True
Less abduction of femora of only 20
True
If a patient has excessive external rotation of one foot, a fractured hip may be indicated.
True
A radiograph of an AP axial (Taylor) “outlet” projection reveals that the obturator foramina are not symmetric. What type of positioning problem is present on this radiograph?
Rotation of the pelvis
During a repeat study of the AP axial (Taylor) outlet projection, both obturator foramina are symmetric but foreshortened. Which of the following positioning modifications must be performed to correct this error?
Increase the cephalic CR angulation.
A patient enters the ER with a possible separation of the symphysis pubis caused by trauma. The AP pelvis projection is inconclusive for determining the extent of the injury. What other projection can be taken to evaluate this region without excessive movement of the patient?
AP axial (Taylor) outlet projection
A patient comes to radiology with a request for a right hip study. He is from an extended care facility and is confusedabout the cause of the injury. The technologist takes an AP pelvis, and when the lateral frog-leg projection is attempted, the patient complains loudly about the pain in his affected hip. What should the technologist do to complete the study?
Perform the axiolateral (inferosuperior) projection.
A patient enters the ER with possible bilateral fractured hips. Which of the following routines should be performed?
AP pelvis and modified axiolateral (Clements-Nakayama method) projections for both hips
A patient comes to the ER with a possible pelvic ring fracture. The initial AP pelvis projection is inconclusive. What other projection can be taken to assist with the diagnosis?
AP axial inlet projection
A radiograph of an AP pelvis demonstrates that the right obturator foramen is foreshortened but the left foramen is open. Which one of the following positioning errors is present on this radiograph?
Right rotation
A patient enters the ER with a possible pelvic ring fracture due to a MVA. The initial pelvis projections do not reveal any fracture or dislocation, but the ER physician is concerned about a possible right acetabular fracture. Which of the following projections will best demonstrate the right acetabulum?
Posterior oblique pelvis projection (Judet method)
Which of the following lateral hip projections cannot be performed on a trauma patient with a possible hip fracture?
Modified Cleaves method
Which of the following projections requires that the IR be tilted 15
Modified axiolateral projection (Clements-Nakayama method)
Which of the following imaging modalities will best detect early signs of bone infection of the pelvis?
Nuclear medicine
A study of a prosthetic hip demonstrates that the end of the prosthesis is cut off on the AP projection, but the entire device is demonstrated on the lateral projection. What should the technologist do next?
Repeat the AP projection only.
How much CR angle, from the horizontal, is required for the modified axiolateral (Clements-Nakayama) projection?
15
Malignancy spread to bone via the circulatory, lymphatic systems, or direct invasion
Metastatic carcinoma
A disease producing extensive calcification of the longitudinal ligament of the spinal column
Ankylosing spondylitis
A degenerative joint disease
Osteoarthritis
A malignant tumor of the cartilage
Chondrosarcoma
Now referred to as “developmental dysplasia of the hip”
Congenital dislocation of hip
A fracture resulting from a severe blow to one side of the pelvis
Pelvic ring fracture
Fractures that occur in adolescent athletes who experience sudden, forceful, or unbalanced contraction of the tendinous and muscular attachments on the bony pelvis.
Avulsion fracture