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Hip Arthritis Fomeral Head

FIGURE 3.25. (A) An anteroposterior (AP) radiograph of the pelvis is centered low to include the hips. Performed properly, this provides good radiographic assessment of the hip in the AP plane. Additionally, it allows radiographic visualization of the surrounding structures, including the lumbosacral junction, sacrum, coccyx, sacroiliac joint, ilium, ischium, and pubis. Of equal importance, it provides a comparison view of the contralateral hip, which is often helpful when trying to interpret subtle irregularities or variations present in the affected hip. (B) The frog lateral provides an excellent radiographic view of the proximal femur in a perpendicular plane to the AP film.

FIGURE 3.25. (A) An anteroposterior (AP) radiograph of the pelvis is centered low to include the hips. Performed properly, this provides good radiographic assessment of the hip in the AP plane. Additionally, it allows radiographic visualization of the surrounding structures, including the lumbosacral junction, sacrum, coccyx, sacroiliac joint, ilium, ischium, and pubis. Of equal importance, it provides a comparison view of the contralateral hip, which is often helpful when trying to interpret subtle irregularities or variations present in the affected hip. (B) The frog lateral provides an excellent radiographic view of the proximal femur in a perpendicular plane to the AP film.

of the joint, it provides less useful information about the proximal femur and adds little to interpretation of the acetabulum as a routine screening tool.

Varying degrees of degeneration may be apparent ra-diographically with either inflammatory or oteoarthritic disorders and are readily recognized. However, subtle findings may be associated with various forms of in-traarticular pathology. Just as is commonly seen in the knee, significant articular surface damage apparent at ar-throscopy may be related to only subtle radiographic evidence of joint space narrowing on radiographs that could be superficially interpreted as normal (Figure 3.27).

Femoral Head Arthritis

FIGURE 3.27. (A) AP pelvis radiograph of a 74-year-old woman with chronic rheumatoid arthritis who presented with recent onset of intractable mechanical left hip pain. Radiographs were reported as superficially normal with only modest evidence of inflammatory degenerative changes, insufficient to solely explain the magnitude of her symptoms. (B) Arthroscopic view of the left hip from the an-terolateral portal revealing extensive articular surface erosion of both the femoral head (F) and acetabulum (A) with area of exposed bone (*) and extensive synovial disease.

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