Gayle Krystle A. Grey, M.D.

 1. Three Rings
 2. Joint Spaces
 3. Acetabulum
 4. Sacral Foramina
 5. Proximal Femur

Murphy, A. & Jones, J. Pelvic Radiograph: An Approach. Radiopedia Org., accessed online 2019
  1. Three Rings
 2. Joint Spaces
 3. Acetabulum
 4. Sacral Foramina
 5. Proximal Femur

Murphy, A. & Jones, J. Pelvic Radiograph: An Approach. Radiopedia Org., accessed online 2019
  1. Three Rings
 2. Joint Spaces
 3. Acetabulum
 4. Sacral Foramina
 5. Proximal Femur

Murphy, A. & Jones, J. Pelvic Radiograph: An Approach. Radiopedia Org., 2019

  1. Three Rings
 2. Joint Spaces
 3. Acetabulum
 4. Sacral Foramina
 5. Proximal Femur

Murphy, A. & Jones, J. Pelvic Radiograph: An Approach. Radiopedia Org., accessed online 2019
  1. Three Rings
 2. Joint Spaces
 3. Acetabulum
 4. Sacral Foramina
 5. Proximal Femur

Murphy, A. & Jones, J. Pelvic Radiograph: An Approach. Radiopedia Org., accessed online 2019
  1. Three Rings
 2. Joint Spaces
 3. Acetabulum
 4. Sacral Foramina
 5. Proximal Femur

Murphy, A. & Jones, J. Pelvic Radiograph: An Approach. Radiopedia Org., accessed online 2019
  Technique
 Patient is supine
 Lower limbs are internally rotated 15-25° from the hip

 Technicalities
 Entirety of the bony pelvis is imaged from superior of the iliac crest to the proximal shaft
of the femur
 Obturator foramina appear equal
 Iliac wings have an equal concavity
 Greater trochanters of the proximal femur are in profile

Young JW, Burgess AR, Brumback RJ et-al. Pelvic fractures: value of plain radiography in early
assessment and management. Radiology. 1986;160 (2): 445-51
  Technique
 Patient is supine
 Lower limbs are internally rotated 15-25° from the hip
 Centering point is midline at the level of the anterior superior iliac spine
 The central ray is angled 25-40° caudal to be perpendicular to the plane of the pelvic
inlet

 Technicalities
 The entirety of the bony pelvic rim is central to the image without superimposition
 The iliac wings are evident on the superior portion of the image, the inferior and superior
pubic rami are superimposed on the inferior portion.

Ricci WM, Mamczak C, Tynan M et-al. Pelvic inlet and outlet radiographs redefined. J Bone Joint Surg
Am. 2010;92 (10): 1947-53.
 Technique
 Patient is supine
 Lower limbs are internally rotated 15-25° from the hip
 The central ray is angled 20-35° cephalic for males and 30-45° for females (see figures 2 and
3)

 Technicalities
 The entirety of the bony pelvis is imaged from superior of the iliac crest to the proximal
shaft of the femur.
 The pubic symphysis should be central to the image with little to no patient rotation.
 There is a clear demonstration of both the anterior and inferior pubic ramus with little to no
foreshortening
 Technique
 Patient is supine.
 The affected side is rotated roughly 45° anterior, generally aided by a 45° sponge
 Ensure the patient is central on the table and at no risk of over rolling
 Centering point is 5 cm distal and 5 cm medial of the ASIS that is rolled up anterior to the
image receptor

 Technicalities
 The obturator oblique projection should distinctly show the posterior rim as well as the
anterior ilioischial line. ‘
 As per the name, the obturator foramen is well demonstrated.
 Technique
 Patient is supine
 The unaffected side is rotated roughly 45° anterior, generally aided by a 45° sponge
 It is advisable that the patient is positioned central on the table and at no risk of over-
rolling
 Centering point is 5 cm distal and 5 cm medial of the ASIS closest to the image receptor

 Technicalities
 The iliac oblique projection should demonstrate the anterior rim of the acetabulum as
well as the posterior ilioischial column.
 The iliac wing, as it is 'flattened' out on the image, should be well demonstrated.
  Technique
 Patient is supine with both arms on the chest, the side in question closest to the image
receptor:
 The image receptor is angled approximately 20-45° to match the angle of the neck of
femur (observed on the AP pelvis/ hip) (parallel to the position of the femur)
 before progressing to shooting, the patient's unaffected hip is flexed and abducted

 Technicalities
 The lesser trochanter can be seen in profile, while the proximal femoral shaft
superimposes the greater trochanter.
 There is a clear visualization of the articular surface of the acetabulum and the head
of the proximal femur.
 The opposite leg has been elevated enough that there is no obstructing soft tissue
artefact.

Young JW, Burgess AR, Brumback RJ et-al. Pelvic fractures: value of plain radiography in early assessment and management. Radiology. 1986;160 (2): 445-51