The anteversion of the proximal femur causes the NSA to appear larger on radiographs than it really is. The femoral shaft axis is drawn midway between the lateral and medial borders of the femoral shaft. That line represents the femoral neck axis. The points where the circle intersects the femoral neck are connected.Ī line is drawn perpendicular to that line through the center of the femoral head. The point of deepest concavity on the lateral border of the femoral neck is marked.Īnother arc through that point using the center of the femoral head as the center is drawn. Reference points for the circular arc are the lateral portion (outermost point) of the epiphysis and the medial corner of the femoral neck. ![]() The center of the femoral head is located with a circle template or a computer-assisted technique. Müller uses the following method for an accurate reconstruction of the NSA: A line drawn perpendicular to that line through the center of the femoral head represents the femoral neck axis. Next a line is drawn connecting the points where the circle intersects the medial and lateral borders of the femoral neck. 2.3): first the center of the femoral head is located with a circle template or computer-assisted technique at a workstation. The femoral neck axis can be determined as follows ( Fig. 1 = Iliopectineal line 2 = Ilioischial line 3 = Acetabular roof line 4 = Acetabular teardrop 5 = Posterior rim of acetabulum 6 = Anterior rim of acetabulum a Schematic drawing. Anatomic landmarks for evaluating the hip in the anteroposterior pelvic radiograph. It is the angle formed by the longitudinal axes of the neck and shaft of the femur. 2.2) is determined on the anteroposterior (AP) pelvic radiograph or the AP radiograph of the hip and femur. The projected femoral neck–shaft angle (NSA, called also the caput–collum–diaphyseal (CCD) angle Fig. The quadrilateral plate is the posterior wall of the acetabulum, which faces inward on the pelvic inlet and presents an approximately square, flat surface.Īrmbuster TG, Guerra J Jr, Resnick D, et al. The ilioischial line is the landmark for the posterior column.Īcetabular teardrop: This is a teardrop-shaped figure formed laterally by the medial portion of the acetabulum and medially by the antero-inferior portion of the quadrilateral plate. Ilioischial line: The upper portion of this line is formed by the posterior part of the quadrilateral plate, its lower portion by the ischium (medial boundary). Iliopectineal line (arcuate line, linea terminalis): The iliopectineal line is the radiographic reference line for the anterior column. Post-mortem before an autopsy in cases of suspected sudden infant death syndrome (SIDS) to exclude traumatic skeletal injury or skeletal abnormalities indicative of an underlying naturally occurring diseaseĬomputed bone maturity (bone age) assessmentĬomputed bone maturity (bone age) measurement are performed in cases of suspected growth delay or early pubertal development:Ĭomputed tomography scanogram for leg length discrepancy assessmentĬomputed tomography scanogram for leg length discrepancy assessment is performed in patients (children in most of the cases) with suspected inequality in leg length.The following radiographic landmarks and their interrelationships are helpful in diagnosing congenital and acquired abnormalities of the acetabulum ( Fig. Suspected non-accidental pediatric skeletal injury Skeletal surveys are performed in cases of: Hip : figure 1 example normal-pediatric- hip-ultrasound-graf-type-i ![]() Posterior nasal space x-ray: example neededġ2-year old: example 1 (with Rosenberg view)
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