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Ebook Musculoskeletal imaging: Part 2

(BQ) Part 2 book “Musculoskeletal imaging” has contents: Pelvic girdle and hip, knee and tibial injuries, meniscal pathology, anterior cruciate ligament tears, quadriceps tendon injuries, ankle injuries, achilles tendon pathology, atlantoaxial fractures, and other contents. | chapter 6 Pelvic girdle and hip 6.1 Key anatomy The pelvic girdle is formed from five bones: the ilium, the ischium, the pubis, the sacrum and the coccyx (Figure 6.1). The ilium, ischium and pubis fuse to form the acetabulum, a socket for the femoral head at the hip joint. Whereas the head of the humerus lies in the shallow glenoid fossa of the shsoulder joint, the head of the femur sits deep in the acetabulum of the hip joint. This arrangement of femoral head and acetabulum provides more stability but allows a smaller range of movement. M L H G A F I J B E C D K Figure 6.1 Anteroposterior radiograph of the pelvis and hips. A Illium, B pubis, C ischium, D pubic symphysis, E obturator foramen, F acetabulum, G anterior superior iliac spine, H sacrum, I coccyx, J anterior inferior iliac spine, K ischial tuberosity, L arcuate line of sacrum, M sacroiliac joint. Shenton’s line (dashed line) follows the inferior margin of the femoral neck and head and continues along the superior pubic ramus. 96 Pelvic girdle and hip The acetabular labrum is a ring of cartilage around the acetabulum. The labrum helps stabilise the hip joint by deepening the socket. Figures 6.2 and 6.3 show the appearance of the pelvis on magnetic resonance imaging (MRI). Imaging points • When imaging the hip in trauma, obtain a cross-table projection (Figure 6.4) as well as an anteroposterior view of the pelvic (Figure 6.5) • The pelvis can be considered a ring of bone. A fracture in one part of the ring usually indicates a fracture on another part of it • Shenton’s line follows the inferior margin of the femoral neck and head and continues along the superior pubic ramus G H D E F C I A B K L J Figure 6.2 Axial magnetic resonance imaging of the pelvis at the level of the hip joints. A Femoral head, B greater trochanter, C rectus femoris (incidental lipoma posteriorly, arrowhead), D sartorius, E common femoral vessels, F pectineus, G iliopsoas, H tensor fascia latae, I .