Please note that the more views that are obtained of a bone or joint, the higher the sensivity and specificity of plain radiographic imaging becomes in detecting bony abnormalities.īecause the pelvis is a ring-like structure, be wary that a fracture in one part of the ring is often accompanied by damage to bone, ligament or tendon structures at some other point in the structure. However, there are other radiographic views that can provide a more holistic view of the patient’s anatomy, allowing physicians to better visualize occult fractures that are uniquely displaced and that may not appear on the AP or lateral views. Pelvic and hip anterior-posterior (AP) and lateral images are most commonly obtained when assessing for pelvic bony abnormalities as many physicians have greater familiarity with interpreting these particular views. Goel’s excellent post on Pelvic X-rays that provides an excellent review on anatomy and overview on basic radiographic approach.

Pelvic and hip X-rays are most frequently obtained when there is concern for fracture, joint dislocation and effusion, and several pediatric pathologies involving the pelvic girdle which are outlined below.īefore delving into the radiographic approach to pelvic and hip X-rays, let us first review some anatomy.

While it is vital to have a high suspicion for pelvic injuries in high mechanism traumas, continue to have high concern in low energy traumas as well, especially in patients prone to pelvic injury due to underlying pathophysiology, such as the elderly or bone composition deficiencies, as they can lead to high morbidity if not diagnosed early in the course of illness.

Pelvic and hip X-rays are almost always obtained, and with good reason, in patients presenting after significant blunt trauma to rule out bony abnormalities and underlying structural injuries in patients that are unstable or altered, have an abnormal pelvic exam, or have significant distracting injuries. Plain radiographs are a widely available modality that confer benefits of cost effectiveness and promptness, proving them very useful as an initial diagnostic choice when approaching several musculoskeletal concerns, particularly pelvic and hip pathologies.

Xray of normal right hip