Radiographic Evaluation of Hip

Dr Pankaj Narekar, MD. DCA Imaging.

Pelvis
Soft tissue Bones
Iliopectineal line Ilioischial line Shentons line

Acetabular cavity Depth Inclination Version

Femoral Head Sphericity Position of Hip centre Head Neck offset Congruency

Head neck junction & offset

Position femoral head epiphysis DDH & SCFE

Hip Pain
Pediatric
1. 2. 3. 4. 5. 6. Perthes disease DDH SCFE Congenital coxa Vara Trauma Neoplastic

Adult
1. 2. 3. 4. 5. FAI AVN Inflammatory Arthritis OA Transient osteoporosis/ Subchondral insufficiency fracture Trauma Neoplastic

6. 7.

Pincer Impingement Focal or general overcoverag 40 (40-57) Coxa profunda Protrusio acetabuli Focal acetabular retroversion (figure-8 configuration) Lateral center edge angle > 39 Posterior wall sign Ischial spine sign

Cam Impingement Aspherical head 32 (21-51) Pistol-grip deformity CCD angle < 125 offset ratio-0.18 Alpha angle > 50

radiology.rsna.org/content/264/3/651.abstract

Subchondral insufficiency fracture/

Transient Osteoporosis

M>F Elderly patient,3rd trimester of pregnancy.

Focal reduced bone density. Subchondral lucent line. Flattening Step off.

Avascular necrosis

Increased bone density Flattening/ depression Deformity

Infection

Perthes Disease
Idiopathic avscular necrosis of hip 2- 14 yrs M>F Small capital epiphysis Sclerosis Flattening/depression Fragmentation Healing

Evaluation for DDH

SCFE

Take home points

Pelvic Bone
Iliopectineal line Ilioischial line Shentons line

Femoral Head
Sphericity Position of Hip centre Head Neck offset Congruency

THANK YOU