Learning objectives
To describe the most used incidences in conventional radiology assessment of the hip joint.
To review and illustrate the most important lines and angles for evaluation of normal hip anatomy and alignment.
Background
The hip joint is a synovial joint between the acetabulum of the pelvis and the head of the femur,
which connects the axial skeleton with the lower extremity.
Conventional radiography is widely used in the study of hip disease because of its availability,
reliability and low cost.
The most performed incidence is anteroposterior view (AP view).
Other radiographic projections (cross-table lateral,
Dunn,
frog-leg lateral and false-profile) are used when certain pathologies are suspected.
The anteroposterior pelvic and false-profile views provide information regarding acetabular morphology.
On...
Imaging findings OR Procedure Details
There are multiple lines and angles described in hip radiographic evaluation which provide diagnostic clues for several disorders (congenital,
acquired or degenerative).
Lines and Angles for Radiographic Evaluation of Hip Joint
1.
Acetabular index
2.
Alpha angle
3.
Center-edge angle of Wiberg
4.
Femoral neck angle (CCD angle)
5.
Hip joint space
6.
Ilioischial line (Köhler line)
7.
Iliopectinealline
8.
Shenton´s line
9.
Skinner’s (femoral angle) line
10.
Teardrop distance
11.
Tönnis angle
1.
Acetabular index (or Acetabular angle of Sharp)
Indication: Measures acetabular inclination...
Conclusion
Conventional radiology is the chosen method of assessment of the hip joint.
The radiologist should be familiar with the normal appearance of the hip joint and ensure that the patient positioning was appropriate.
Radiographic measurements are a useful tool to evaluate normal anatomy and recognize signs of pathology.
Nevertheless,
an accurate diagnosis can only be obtained by interpreting radiographic findings together with the patient history and physical examination.
References
1 - Bontrager K.
Textbook of Radiologic positioning and related anatomy.
2014.
Mosby Elsevier;
2 - Campbell SEl.
Radiography of the Hip: Lines,
Signs,
and Patterns of Disease.
2005.
Seminars in Roentgenology;
3 - Clohisy JC,
Carlisle JC,et al.
A Systematic Approach to the Plain Radiographic Evaluation of the Young Adult Hip. 2008.
The Journal of Bone and Joint Surgery;
4 - Keats TE.
Atlas de Medidas Radiologicas.
Mosby.
2002.Elsevier España;
5 - Lim SJ,
Park YS .
Plain Radiography of the Hip: A Review...
Personal Information
Lead author: Dr Ana Luísa Proença,
Radiology Resident at Centro Hospitalar Lisboa Central,
Lisbon.
A special thanks to radiographer António Dias and the model Maria Adelaide Sousa for the collaboration on this work.