Pelvis series

Changed by Andrew Murphy, 6 May 2016

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The pelvis series is comprised of an anteroposterior (AP) with additional projections based on indications and pathology. The series is used most in emergency departments during the evaluation of multi-trauma patients due to the complex anatomy the AP projection covers.

The pelvis series examines the main pelvic ring, obturator foramina, sacroiliac joints, symphysis pubis, acetabulum, sacral foramina, and the proximal femur.

The AP pelvis has a diagnostic yield of ~94% in severely injured patients ^2-3.

See an approach to the pelvic radiograph.

Indications

Pelvic radiographs are performed for a variety of indications including ^1-4:

blunt trauma
generalised hip pain
arthropathy
post operative follow up after THR
paget's disease
fall

Projections

Standard projections

AP
- demonstrates the pelvis in the natural anatomical position
- ~~the~~ arcuate, ~~illiopublic, illioichial~~ilioischial and ~~shentons~~shenton lines are ~~easily~~ examined on this view

Additional projections

inlet view
- caudal projection to best demonstrate the main pelvic ring and associated pathology
- best view for evaluation of the posterior displacement of both the main pelvic ring and fractures of the pubic symphysis
outlet view
- cephalic projection ~~best~~ for evaluation of suspected ~~vertical~~cephalad shift of the ~~hemipelvis~~hemipelvis
- tangential view to the inlet view
judet view (oblique)
- for evaluation of ~~suspected fractures~~the superior, medial, lateral, and posterior surfaces of the acetabulum⁵

-<p>The<strong> pelvis series </strong>is comprised of an anteroposterior (AP) with additional projections based on indications and pathology. The series is used most in emergency departments during the evaluation of multi-trauma patients due to the complex anatomy the AP projection covers.</p><p>The pelvis series examines the main pelvic ring, obturator foramina, <a title="Sacroiliac joint" href="/articles/sacroiliac-joint">sacroiliac joints</a>, <a title="Symphysis pubis" href="/articles/symphysis-pubis">symphysis pubis</a>, <a title="Acetabulum" href="/articles/acetabulum">acetabulum</a>, <a title="Sacrum" href="/articles/sacrum">sacral foramina</a>, and the proximal femur.</p><p>The AP pelvis has a diagnostic yield of ~94% in severely injured patients <sup>2-3</sup>.</p><p>See an approach to the <a title="Pelvic radiograph (an approach)" href="/articles/pelvic-radiograph-an-approach">pelvic radiograph</a>.</p><h4>Indications</h4><p>Pelvic radiographs are performed for a variety of indications including <sup>1-4</sup>: </p><ul>
+<p>The<strong> pelvis series </strong>is comprised of an anteroposterior (AP) with additional projections based on indications and pathology. The series is used most in emergency departments during the evaluation of multi-trauma patients due to the complex anatomy the AP projection covers.</p><p>The pelvis series examines the main pelvic ring, obturator foramina, <a href="/articles/sacroiliac-joint">sacroiliac joints</a>, <a href="/articles/symphysis-pubis">symphysis pubis</a>, <a href="/articles/acetabulum">acetabulum</a>, <a href="/articles/sacrum">sacral foramina</a>, and the <a href="/articles/femoral-neck-fracture">proximal femur</a>.</p><p>The AP pelvis has a diagnostic yield of ~94% in severely injured patients <sup>2-3</sup>.</p><p>See an approach to the <a href="/articles/pelvic-radiograph-an-approach">pelvic radiograph</a>.</p><h4>Indications</h4><p>Pelvic radiographs are performed for a variety of indications including <sup>1-4</sup>: </p><ul>
~~-<li>post operative follow up after <a title="Total hip replacement" href="/articles/total-hip-arthroplasty">THR</a> </li>~~
~~-<li>paget's disease </li>~~
+<li>post operative follow up after <a href="/articles/total-hip-arthroplasty">THR</a> </li>
+<li>
+<a href="/articles/paget-disease-of-bone-2">paget's</a> disease </li>
~~-</ul><h4>Projections</h4><h5>Standard projections</h5><ul><li>~~
~~-<a href="/articles/ankle-ap-view">AP</a><ul>~~
+</ul><h4>Projections</h4><h5>Standard projections</h5><ul><li>AP<ul>
~~-<li>the arcuate, illiopublic, illioichial and shentons lines are easily examined on this view </li>~~
~~-<li>able to asses the main pelvic ring, obturator foramina, sacroiliac joints, symphysis pubis, acetabulum, sacral foramina, and the proximal femur</li>~~
+<li>arcuate, ilioischial and shenton lines are examined on this view </li>
~~-</li></ul><p> </p><h5>Additional projections</h5><ul>~~
+</li></ul><h5>Additional projections</h5><ul>
~~-<li>best view for evaluation of the posterior displacement of both the main pelvic ring and fractures of the <a title="Pubic symphysis" href="/articles/symphysis-pubis">pubic symphysis</a> </li>~~
+<li>best view for evaluation of the posterior displacement of both the main pelvic ring and fractures of the <a href="/articles/symphysis-pubis">pubic symphysis</a> </li>
~~-<li>cephalic projection best for evaluation of suspected vertical shift of the hemipelvis </li>~~
+<li>cephalic projection for evaluation of suspected <a href="/articles/malgaigne-fracture">cephalad shift of the hemipelvis</a> </li>
~~-<li>judet view (oblique)<ul><li>for evaluation of suspected fractures of the bones that make up the <a title="Acetabulum" href="/articles/acetabulum">acetabulum</a>~~
~~-</li></ul>~~
+<li>judet view (oblique)<ul><li>for evaluation of the superior, medial, lateral, and posterior surfaces of the <a href="/articles/acetabulum">acetabulum</a> <sup>5</sup> </li></ul>

References changed:

1. Ricci WM, Mamczak C, Tynan M et-al. Pelvic inlet and outlet radiographs redefined. J Bone Joint Surg Am. 2010;92 (10): 1947-53. <a href="http://dx.doi.org/10.2106/JBJS.I.01580">doi:10.2106/JBJS.I.01580</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/20720137">Pubmed citation</a><span class="auto"></span>
2. Young JW, Burgess AR, Brumback RJ et-al. Pelvic fractures: value of plain radiography in early assessment and management. Radiology. 1986;160 (2): 445-51. <a href="http://www.ncbi.nlm.nih.gov/pubmed/3726125">Pubmed citation</a><span class="auto"></span>
3. Alton TB, Gee AO. Classifications in brief: young and burgess classification of pelvic ring injuries. Clin. Orthop. Relat. Res. 2014;472 (8): 2338-42. <a href="http://dx.doi.org/10.1007/s11999-014-3693-8">doi:10.1007/s11999-014-3693-8</a> - <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079881">Free text at pubmed</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/24867452">Pubmed citation</a><span class="auto"></span>
4. Dähnert W. Radiology Review Manual. LWW. (2011) ISBN:1609139437. <a href="http://books.google.com/books?vid=ISBN1609139437">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/1609139437">Find it at Amazon</a><span class="auto"></span>
5. Hutt JR, Ortega-Briones A, Daurka JS et-al. The ongoing relevance of acetabular fracture classification. Bone Joint J. 2015;97-B (8): 1139-43. <a href="http://dx.doi.org/10.1302/0301-620X.97B8.33653">doi:10.1302/0301-620X.97B8.33653</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/26224834">Pubmed citation</a><span class="auto"></span>

Sections changed:

Radiography

Systems changed:

Musculoskeletal

Images Changes:

Image 1 Annotated image (Female) ( create )

Image 2 Annotated image (Male) ( create )

Image 3 X-ray (Judet view (RPO - left hip elevated)) ( create )

Image 4 X-ray (Judet view (LPO - right hip elevated)) ( create )

Image 7 ( create )

Image 8 ( create )

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