![]() ![]() The lifetime risk of symptomatic hip osteoarthritis in people reaching the age of 85 years was estimated to be as high as 25% in certain regions 2. Reported prevalence varies in different studies and is also subject to geographic conditions. Women are more commonly affected than men. For those patients with values greater than 10 degrees, they are potentially at risk for structural instability of the hip consistent with acetabular dysplasia ( 21).The hip is the third most common joint affected by osteoarthritis after the knee and the hand 1. ![]() In patients with values less than 0 degree, they are considered to be at risk for pincer FAI. Normative values are from 0 to 10 degrees with values less than 0 degree and greater than 10 degrees to be considered decreased and increased, respectively ( 21). The angle made between Lines 2 and 3 represents the acetabular inclination. A third line is then made connecting the superolateral portion of the sourcil and the previously determined inferomedial sourcil (Line 3). To obtain this measurement, a line is drawn connecting the ischial tuberosities or the teardrops to correct for pelvic obliquity (Line 1) a second line is drawn parallel to this line, intersecting through the inferomedial portion of the acetabular sourcil (Line 2). On the acetabular side, the acetabular inclination, or Tönnis angle, can be measured to get an appreciation of the inclination of the weight-bearing portion of the acetabulum ( Fig. The AP pelvic radiograph can provide information regarding both the acetabulum and femoral osseous morphology. LCEA, lateral center edge angle COS, crossover sign PWS, posterior wall sign PRIS, prominent ischial spine sign ACEA, anterior center edge angle AIIS, anterior inferior iliac spine. Table 12.1 Summary of Radiographic Views and the Parameters Used for Evaluation of the HipĬongruency of femoral head and acetabulumĪnterolateral and inferomedial joint space However, the sacrococcygeal junction can be difficult to interpret and thus the tip of the coccyx can be used as another reference point when measuring to the superior border of the pubic symphysis, using a range of 1 to 3 cm for males and 2 to 5 cm for females ( Fig. For males, this distance is 3.2 cm, and in females, is 4.7 cm ( 19). Acceptable pelvic tilt has been further defined based on the patient’s gender and is evaluated by measuring the distance between the sacrococcygeal junction and the superior border of the pubic symphysis. Neutral pelvic rotation is defined as the tip of the coccyx being in line with the midpoint of the superior border of the pubic symphysis with symmetrical appearance of the obturator foramen and iliac wings ( 4). The appearance of acetabular morphology can vary widely depending on the tilt and rotation of the pelvis and thus parameters have been set to provide a reference for standardization. The beam should also be centered over the midpoint between a line connecting the anterosuperior iliac spines and the superior border of the pubic symphysis ( Fig. The distance between the radiographic detector and the beam should be 120 cm and oriented perpendicular to the table. The AP pelvic view should be obtained with the patient in the supine position with the legs internally rotated 15 degrees to compensate for femoral anteversion and allow for accurate assessment of the femoral offset and neck-shaft angle ( 17). ![]()
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