Radiographic Evaluation

For pelvic and hip pathology, radiographic evaluation can prove to be a relatively quick and inexpensive first line of imaging. Care should be taken to limit the exposure to X-radiation in accordance with as low as reasonably practicable (ALARP) principle, and appropriate gonadal shielding should be used whenever possible. There are various radiographic projections that are used for the evaluation of pelvis and both hip joints. The most commonly used projections are anteroposterior (AP), AP axial (frog-leg), and posterior oblique (Judet) views. Other projections include AP axial “outlet,” AP axial “inlet,” oblique for sacroiliac joints, anteroposterior or posteroanterior and lateral projections for sacrum and coccyx, AP and lateral projections for the hip, axio-lateral inferosuperior projection of hip, and projections for arthrographic evaluation. Different projections help in proper visualization and evaluation of various bones and joints of the pelvic region. This chapter includes detailed elaboration of specific patient positioning, direction and centering of X-ray beam for obtaining different radiographic projections of pelvis with both hip joints, as well as appropriate radiograph of each projection.