Types of X-Rays or Imaging the Hip

Patients are placed in standardized positions or “views” which were developed to facilitate quick recognition of normal versus abnormal bone structure. In the case of radiographs of the hip, the most frequently used views are:

• Anteroposterior (AP) hip
• Lateral (“frog-leg”)
• AP Pelvis, including upper femora (bilateral)

Radiographs are commonly used to evaluate hip fractures, bone lesions or arthritis. They are also the initial imaging modality of choice for evaluating a patient with hip pain, or evaluating a patient following trauma. Other imaging techniques which may be used for supplemental information include:

• CT- can be helpful for complex fractures and dislocations;
• MRI- is now the modality of choice for identifying occult fractures, hip pain of unknown etiology, infection, tumor and osteonecrosis;
• Bone scans- can be used to identify subtle fractures or avascular necrosis when MRI is not readily available;
• Arthrography– evaluates joint anatomy, particularly the acetabular labrum, articular cartilage and ligaments.

Most hospitals perform only a lateral hip and an AP pelvis, but for this module we will demonstrate both an AP pelvis film and an AP hip film for the purposes of teaching the anatomy.