Hip joint x-ray is a radiography examination conducted to assess the condition of the acetabulum of the ilium, the head, neck and the area of the trochanter of the femur. In traumatology, it is used in cases of suspected fracture of the femoral head and neck, transvertebral and intervertebral fracture, separation of the large trochanter or dislocation of the femur, as well as in osteomyelitis. In other areas of medicine, it is used in the diagnosis of inflammatory and degenerative-dystrophic diseases, congenital anomalies, primary and metastatic neoplasms of this localization.
The most common indication for hip x-ray is a suspected fracture of the femoral neck (usually in elderly patients). Less often, the study is prescribed for suspected hip dislocation, separation of the large trochanter, intervertebral or transvertebral fracture. In addition, X-ray examination of this area in traumatology is indicated for osteomyelitis of the proximal femur. In orthopedics, the technique is used for arthrosis, osteoporosis, aseptic necrosis, cystic restructuring and malformations (dysplasia). In purulent surgery, the procedure is performed for purulent arthritis, in oncology – for primary or metastatic tumors, in rheumatology – for rheumatological diseases with hip joint damage.
Methodology of conducting
The standard study is performed in the main (direct) and one of the additional projections. Additional projections during hip joint x-ray are lateral and posterior oblique projections with hip abduction. The choice of projections is determined by the nature of pathological changes. To take a picture in a direct projection, the patient is placed on his back. Legs are straightened. The foot on the side of the lesion is turned inward. This position allows a good look at the medial part of the femoral neck and diagnose medial fractures of this localization as accurately as possible.
Radiographs in additional oblique and lateral projections are also performed in the patient’s position on the back with a straightened healthy leg. To take an oblique picture, the leg on the side of the lesion is bent at the knee joint and turned outward. If a hip fracture is suspected in the neck area, it is not recommended to take an oblique picture, since turning the hip outwards can cause the fragments to shift. An X-ray in a lateral projection is made by bending the diseased leg at an angle of 90 degrees in the knee and hip joints and placing the heel on a special stand. The X-ray tube in the latter case is located on the side, on the side of the patient’s healthy leg.
It will not be possible to find out what the pelvic X-ray shows, if we are talking about a pregnant woman or a child under the age of 15. However, the decision in any case should be made by the doctor. If there is a threat to the patient’s life, an X-ray will still be performed. If a child is suspected of hip dysplasia, most likely, it is impossible to do without radiography.