Deck 7: Femur and Pelvic Girdle

Question 1

The two bony landmarks that are palpated using the hip localization method are the:

A) ischial spine and the symphysis pubis.
B) symphysis pubis and the greater trochanter.
C) ASIS and the crest of ilium.
D) ASIS and the symphysis pubis.

Answer 1

ASIS and the symphysis pubis.

Question 2

Which of the following structures is considered to be most inferior or distal?

A) Fovea capitis
B) Lesser trochanter
C) Neck
D) Greater trochanter

Answer 2

Lesser trochanter

Question 3

Select the correct gender to correspond with the following pelvic characteristics.Wider and shallow general shape of pelvis:

A) Male
B) Female

Answer 3

Female

Question 4

The sacroiliac joints are classified as ____ joints with ____ mobility.

A) cartilaginous; amphiarthrodial
B) synovial; amphiarthrodial
C) cartilaginous; synarthrodial
D) fibrous; amphiarthrodial

Question 5

Why must the lower limb be rotated 15° to 20° internally for AP hip projections?

A) To separate the greater trochanter from the lesser trochanter
B) To place the fovea capitis into a profiled position
C) To open up the femoroacetabular joint
D) To place the femoral neck parallel to the image receptor

Question 6

Select the correct gender to correspond with the following pelvic characteristics.Narrower,deeper general shape of pelvis:

A) Male
B) Female

Question 7

Select the correct gender to correspond with the following pelvic characteristics.Acute angle of pubic arch:

A) Male
B) Female

Question 8

Which bone of the pelvic girdle forms the anterior inferior aspect?

A) Ilium
B) Ischium
C) Pubis
D) Sacrum

Question 9

Which bones fuse to form the acetabulum?

A) Ischium and pubis
B) Ilium and ischium
C) Pubis, ilium, and sacrum
D) Ischium, pubis, and ilium

Question 10

Select the correct gender to correspond with the following pelvic characteristics.Round and large pelvic inlet:

A) Male
B) Female

Question 11

The symphysis pubis provides limited movement during pelvic trauma and during:

A) walking and running.
B) flexing and extending.
C) labor and delivery.
D) voiding.

Question 12

The term pelvic girdle refers to the total pelvis including the sacrum and coccyx.

Question 13

Select the correct gender to correspond with the following pelvic characteristics.Obtuse angle of pubic arch:

A) Male
B) Female

Question 14

Which of the labeled structures is the anterior superior iliac spine (ASIS)?

A) A
B) B
C) K
D) J
E)I
F)F
G) E
H) G

Question 15

The lesser sciatic notch is an aspect of the:

A) ilium.
B) ischium.
C) sacrum.
D) pubis.

Question 16

Which of the labeled structures is the body of the ischium?

A) D
B) E
C) F
D) M
E) O

Question 17

Which of the following structures is not an aspect of the proximal femur?

A) Intertrochanteric crest
B) Fovea capitis
C) Obturator foramen
D) Lesser trochanter

Question 18

Select the correct gender to correspond with the following pelvic characteristics.More oval or heart-shaped pelvic inlet:

A) Male
B) Female

Question 19

Using the hip localization method,the femoral head can be located:

A) 1 inch (2.5 cm) below the midpoint of the imaginary line between the two bony landmarks.
B) 1 1/2 inches (4 cm) below the midpoint of the imaginary line between the two bony landmarks.
C) 2 1/2 inches (6 to 7 cm) below the midpoint of the imaginary line between the two bony landmarks.
D) at the level of the symphysis pubis.

Question 20

Which of the following bony structures cannot be palpated?

A) Ischial spine
B) ASIS
C) Ischial tuberosity
D) Symphysis pubis

Question 21

Which of the following imaging modalities can be performed on a newborn to assess hip joint stability during movement?

A) CT
B) Sonography
C) MRI
D) Nuclear medicine

Question 22

What is the amount of abduction of the femurs recommended for an AP bilateral frog-leg projection?

A) 10° to 15°
B) 50° to 60°
C) 40° to 45°
D) 90°

Question 23

Which of the following pathologic conditions is a common type of aseptic or ischemic necrosis?

A) Legg-Calvé-Perthes disease
B) Ankylosing spondylitis
C) Metastatic carcinoma
D) Osteoarthritis

Question 24

What type of CR angle must be used for an AP axial (Taylor method)"outlet" projection for a male patient?

A) 20° to 35° caudad
B) 15° to 20° cephalad
C) 20° to 35° cephalad
D) 0° (CR perpendicular to the image receptor)

Question 25

Where is the CR placed for an AP projection of the pelvis?

A) 1 inch (2.5 cm) above the symphysis pubis
B) At the level of the ASIS
C) At the level of the iliac crest
D) Midway between the ASIS and the symphysis pubis

Question 26

Gonadal shielding should be used on both males and females of childbearing age for AP hip projections,if correctly placed.

Question 27

Gonadal shielding of the male patient for the AP pelvis projection requires that the top of the shield is not extend above the level of the:

A) ASIS.
B) ischial spine.
C) inferior margin of the symphysis pubis.
D) none of the above; gonadal shielding cannot be used due to possible covering of pertinent anatomy.

Question 28

A common condition of the femur that develops in elderly patients,leading to frequent fractures of the hip (proximal femur),is:

A) congenital hip dysplasia.
B) Legg-Calvé-Perthes disease.
C) avascular necrosis
D) developmental dysplasia of the hip.

Question 29

Which of the following conditions will produce shortening of the epiphyses but widening of the epiphyseal plate?

A) Osteoarthritis
B) Legg-Calvé-Perthes disease
C) Slipped capital femur
D) Chondrosarcoma

Question 30

The use of the 80 to 85 kV (analog)technique (as opposed to 70 kV)with a corresponding mAs change for an AP pelvis projection will result in:

A) increased radiographic contrast.
B) improved spatial resolution.
C) reduction in gonadal dose.
D) none of the above; the difference is not measurable.

Question 31

Which of the following conditions will produce the radiographic sign referred to as "bamboo spine"?

A) Osteoarthritis
B) Chondrosarcoma
C) Metastatic carcinoma
D) Ankylosing spondylitis

Question 32

Which of the labeled structures is the superior ramus of pubis?

A) P
B) N
C) L
D) M
E) O

Question 33

Which of the labeled structures is the ischial tuberosity?

A) G
B) F
C) A
D) N

Question 34

Which of the labeled structures is the ischial spine?

A) N
B) M
C) O
D) L
E) P

Question 35

Which of the following positions will best demonstrate signs of developmental dysplasia of the hip?

A) Posterior oblique (Judet method)
B) Axiolateral, inferosuperior (Danelius-Miller method)
C) Taylor method
D) Bilateral frog-leg method

Question 36

Which of the following positions will best demonstrate the posterior (ilioischial)column and anterior (iliopubic)column of the pelvis?

A) Posterior oblique (Judet method)
B) AP axial (Taylor method)
C) RPO and LPO projections
D) Modified axiolateral (Clements-Nakayama method)

Question 37

Which of the following pathologic conditions often occurs in males older than the age of 45 years?

A) Developmental dysplasia of the hip
B) Slipped capital femoral epiphysis
C) Chondrosarcoma
D) Osteoporosis

Question 38

Cephalopelvimetry is still commonly performed in the U.S.

Question 39

Which one of the following projections will best demonstrate a lateral oblique view of the femoral head and neck for the patient with limited movement in both lower limbs?

A) Teufel
B) Axiolateral (inferosuperior) projection
C) AP axial (Taylor)
D) Modified axiolateral (Clements-Nakayama)

Question 40

Which of the labeled structures is the obturator foramen?

A) H
B) L
C) E
D) O
E) P

Question 41

What CR angle is required for the AP axial,inlet projection?

A) 30° cephalad
B) 10° to 15° cephalad
C) 20° to 30° caudad
D) 40° caudad

Question 42

Less abduction of femora of only 20° to 30° from vertical provides for the least foreshortening of femoral necks when performing the AP bilateral "frog-leg" projection.

Question 43

Which of the following projections would be best for a patient with limited movement of both lower limbs (in addition to the AP pelvis)?

A) Modified axiolateral (Clements-Nakayama method)
B) Axiolateral (inferosuperior)
C) Anterior oblique (Teufel method)
D) AP axial (Taylor method)

Question 44

A radiograph of an AP pelvis reveals that the right iliac wing is foreshortened as compared with the left side.What specific positioning problem is present on this radiograph?

A) Left rotation
B) Right rotation
C) Right tilt
D) Incorrect CR centering or angulation

Question 45

A patient enters the ER having sustained trauma to the pelvis.The patient's main complaint is about her left hip.Which of the following projections should be taken first to rule out fracture or dislocation?

A) AP pelvis
B) AP projection of the left hip
C) Axiolateral (inferosuperior) projection of the left hip
D) Lateral frog-leg projection of the left hip

Question 46

How much rotation of the body is required for posterior axial oblique projection (Teufel method)?

A) 45°
B) 35° to 40°
C) 60° to 70°
D) 25° to 30°

Question 47

What type of CR angle is required for the posterior axial oblique projection (Teufel method)?

A) 12° cephalad
B) 10° cephalad
C) 20° to 25° caudad
D) 15° cephalad

Question 48

A radiograph of an AP pelvis reveals that the lesser trochanters are not visualized.This pelvis projection was performed for nontraumatic reasons.What should the technologist do (if anything)to correct this on the repeat exposure?

A) Rotate the lower limbs more internally 15° to 20°.
B) Do nothing. Accept the radiograph and do not repeat the exposure.
C) Ensure that the ASIS is an equal distance from the tabletop.
D) Angle the CR 10° to 15° cephalad.

Question 49

If a patient has excessive external rotation of one foot,a fractured hip may be indicated.

Question 50

A PA axial oblique projection (Teufel method)is performed on a patient.The resultant radiograph demonstrates distortion of the acetabulum.The following positioning factors were used: 40° anterior oblique,12° cephalad CR angle,and CR centered to the upside hip (acetabulum).What needs to be modified during the repeat exposure?

A) Increase CR angle to 15° cephalad.
B) Change CR angle to 12° caudad.
C) Increase rotation of anterior oblique to 45°.
D) Center CR to downside hip (acetabulum).

Question 51

A radiograph of an axiolateral (inferosuperior)projection of the hip reveals a soft tissue artifact seen across the affected hip.This artifact prevents a clear view of the femoral head and neck.What must the technologist do to eliminate this artifact or its effect during the repeat exposure?

A) Increase the kV.
B) Ensure that the CR is centered to the grid to prevent grid cutoff.
C) Increase the elevation and flexion of the patient's unaffected leg.
D) Slightly rotate the patient toward the affected side and angle 5° caudad.

Question 52

The proper name of the method used for the unilateral frog-leg projection is the _____ method.

A) Danelius-Miller
B) modified Cleaves
C) Teufel
D) Taylor

Question 53

The image receptor must be placed parallel to the femoral neck for the axiolateral (inferosuperior)projection of the hip.

Question 54

The posterior oblique (Judet method)for the acetabulum requires a 10° to 15° rotation of the body.

Question 55

A nontrauma patient comes to radiology with a history of chronic pain of the right hip.The patient is ambulatory but has not had previous radiographs taken of that hip.Which of the following routines would be best suited for this patient?

A) AP and axiolateral (inferosuperior) projections of the right hip
B) AP pelvis and axiolateral frog-leg (modified Cleaves) projections of the right hip
C) AP pelvis and modified axiolateral (Clements-Nakayama) projections of right hip
D) AP pelvis and AP axial (Taylor method) projections of right hip

Question 56

A radiograph of an axiolateral (inferosuperior)projection reveals that there is an excessive amount of grid lines present.A 6:1 linear grid was used.Which of the following points will correct this problem on the repeat exposure?

A) Use a screen rather than a grid.
B) Decrease the SID.
C) Keep the image receptor parallel to the femoral neck and perpendicular to CR.
D) Keep the image receptor perpendicular to the femoral neck.

Question 57

A radiograph of an AP pelvis reveals that the left obturator foramen is more open or elongated as compared with the right.What is the specific positioning error present on this radiograph?

A) Left rotation
B) Right rotation
C) Left tilt
D) Incorrect CR centering or angulation

Question 58

Only a small part of the lesser trochanter,if any,will be visible on a well-positioned axiolateral (inferosuperior)lateral hip.

Question 59

Generally,gonadal shielding for females cannot be used for an initial AP pelvis for pelvic trauma due to the possibility of covering pertinent anatomy.

Question 60

A radiograph of a unilateral frog-leg (modified Cleaves method)projection reveals that the femoral neck is foreshortened and distorted.The radiologist is concerned about pathology involving the neck.What can the technologist do to improve the visibility of the femoral neck without foreshortening during the repeat exposure?

A) Use a 20° to 25° cephalad CR angle.
B) Decrease the abduction of the femur to 20° to 30° from vertical.
C) Oblique the patient 35° to 45° toward the affected side with femur abducted to be in contact with tabletop.
D) Increase the abduction of the femur to about 60° to 70° from vertical.

Question 61

A study of a prosthetic hip demonstrates that the end of the prosthesis is cut off on the AP projection,but the entire device is demonstrated on the lateral projection.What should the technologist do next?

A) Repeat both the AP and lateral projections.
B) Repeat the AP projection only.
C) Ask another technologist for his or her opinion.
D) Ask the radiologist if he or she wants the AP projection repeated.

Question 62

Which of the following lateral hip projections cannot be performed on a trauma patient with a possible hip fracture?

A) Modified Cleaves method
B) Clements-Nakayama
C) Danelius-Miller
D) Judet method

Question 63

A radiograph of an AP pelvis demonstrates that the right obturator foramen is foreshortened but the left foramen is open.Which one of the following positioning errors is present on this radiograph?

A) Right rotation
B) Left rotation
C) Right tilt
D) Excessive CR angle

Question 64

MATCHING
Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.)
Fractures that occur in adolescent athletes who experience sudden,forceful,or unbalanced contraction of the tendinous and muscular attachments on the bony pelvis.

A)Metastatic carcinoma
B)Ankylosing spondylitis
C)Congenital dislocation of hip
D)Chondrosarcoma
E)Pelvic ring fracture
F)Osteoarthritis
G)Avulsion fracture

Question 65

MATCHING
Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.)
A fracture resulting from a severe blow to one side of the pelvis

A)Metastatic carcinoma
B)Ankylosing spondylitis
C)Congenital dislocation of hip
D)Chondrosarcoma
E)Pelvic ring fracture
F)Osteoarthritis
G)Avulsion fracture

Question 66

A patient enters the ER with a possible pelvic ring fracture due to a MVA.The initial pelvis projections do not reveal any fracture or dislocation,but the ER physician is concerned about a possible right acetabular fracture.Which of the following projections will best demonstrate the right acetabulum?

A) AP axial inlet projection
B) Axiolateral inferosuperior projection (Danelius-Miller method)
C) Modified axiolateral projection (Clements-Nakayama method)
D) Posterior oblique pelvis projection (Judet method)

Question 67

MATCHING
Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.)
A degenerative joint disease

A)Metastatic carcinoma
B)Ankylosing spondylitis
C)Congenital dislocation of hip
D)Chondrosarcoma
E)Pelvic ring fracture
F)Osteoarthritis
G)Avulsion fracture

Question 68

A patient comes to the ER with a possible pelvic ring fracture.The initial AP pelvis projection is inconclusive.What other projection can be taken to assist with the diagnosis?

A) AP axial inlet projection
B) AP, bilateral (modified Cleaves method) frog-leg projection
C) Modified axiolateral projections
D) Posterior axial oblique projections

Question 69

MATCHING
Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.)
A disease producing extensive calcification of the longitudinal ligament of the spinal column

A)Metastatic carcinoma
B)Ankylosing spondylitis
C)Congenital dislocation of hip
D)Chondrosarcoma
E)Pelvic ring fracture
F)Osteoarthritis
G)Avulsion fracture

Question 70

MATCHING
Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.)
Now referred to as "developmental dysplasia of the hip"

A)Metastatic carcinoma
B)Ankylosing spondylitis
C)Congenital dislocation of hip
D)Chondrosarcoma
E)Pelvic ring fracture
F)Osteoarthritis
G)Avulsion fracture

Question 71

During a repeat study of the AP axial (Taylor)outlet projection,both obturator foramina are symmetric but foreshortened.Which of the following positioning modifications must be performed to correct this error?

A) Increase the cephalic CR angulation.
B) Increase the caudal CR angulation.
C) Correct for rotation.
D) Use a perpendicular CR.

Question 72

A patient comes to radiology with a request for a right hip study.He is from an extended care facility and is confused about the cause of the injury.The technologist takes an AP pelvis,and when the lateral frog-leg projection is attempted,the patient complains loudly about the pain in his affected hip.What should the technologist do to complete the study?

A) Continue to position the patient, but move the affected limb more gently.
B) Perform the AP pelvis projection only.
C) Perform the axiolateral (inferosuperior) projection.
D) Perform the anterior pelvis (Taylor) outlet projection.

Question 73

Which of the following projections requires that the IR be tilted 15° from the vertical plane?

A) AP axial inlet projection
B) Axiolateral inferosuperior projection (Danelius-Miller method)
C) Modified axiolateral projection (Clements-Nakayama method)
D) Posterior axial oblique projection (Teufel method)

Question 74

MATCHING
Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.)
Malignancy spread to bone via the circulatory,lymphatic systems,or direct invasion

A)Metastatic carcinoma
B)Ankylosing spondylitis
C)Congenital dislocation of hip
D)Chondrosarcoma
E)Pelvic ring fracture
F)Osteoarthritis
G)Avulsion fracture

Question 75

A patient enters the ER with possible bilateral fractured hips.Which of the following routines should be performed?

A) AP pelvis and axiolateral (inferosuperior) projections for both hips
B) AP pelvis and modified axiolateral (Clements-Nakayama method) projections for both hips
C) AP pelvis and bilateral frog-leg projections
D) AP pelvis and posterior oblique (Judet) projections

Question 76

MATCHING
Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.)
A malignant tumor of the cartilage

A)Metastatic carcinoma
B)Ankylosing spondylitis
C)Congenital dislocation of hip
D)Chondrosarcoma
E)Pelvic ring fracture
F)Osteoarthritis
G)Avulsion fracture

Question 77

A patient enters the ER with a possible separation of the symphysis pubis caused by trauma.The AP pelvis projection is inconclusive for determining the extent of the injury.What other projection can be taken to evaluate this region without excessive movement of the patient?

A) Posterior oblique (Judet) projection
B) AP axial "inlet" projection
C) Axiolateral (inferosuperior) projection
D) AP axial (Taylor) outlet projection

Question 78

A radiograph of an AP axial (Taylor)"outlet" projection reveals that the obturator foramina are not symmetric.What type of positioning problem is present on this radiograph?

A) Tilt of the pelvis
B) Off-center CR
C) Rotation of the pelvis
D) Probable fracture of the pubis or ischium

Question 79

How much CR angle,from the horizontal,is required for the modified axiolateral (Clements-Nakayama)projection?

A) None. The IR must be keep perpendicular to the tabletop.
B) 5° to 10°
C) 15° to 20°
D) 25° to 30°

Question 80

Which of the following imaging modalities will best detect early signs of bone infection of the pelvis?

A) Radiography
B) CT
C) Nuclear medicine
D) MRI