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SYMPOSIUM Table of Contents   
Year : 2002  |  Volume : 36  |  Issue : 1  |  Page : 8-9
Radiology of acetabular fractures


Dr Jankharia's Imaging Centre, Mumbai, India

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How to cite this article:
Jankharia B, Sosi N. Radiology of acetabular fractures. Indian J Orthop 2002;36:8-9

How to cite this URL:
Jankharia B, Sosi N. Radiology of acetabular fractures. Indian J Orthop [serial online] 2002 [cited 2020 Jan 19];36:8-9. Available from: http://www.ijoonline.com/text.asp?2002/36/1/8/35913
Because of its complex anatomy, imaging of the acetabulum typically has posed many problems. In the past, plain radiographs were used extensively. Today, plain x-rays are supplemented with CT and 3DCT for the evaluation of acetabular trauma. [1]

Plain radiographs

To fully understand the anatomy, radiographs need to be obtained in multiple projections. The standard radiographs include the AP view and the Judet views, which are oblique views with 45 degrees rotation. Inlet and outlet views are more useful for associated injuries of the pelvic ring.

CT

A standard CT in the axial plane [Figure 1] clearly shows the various parts of the acetabulum. However, fracture patterns and classification are best understood using sagittal and coronal reconstructions [Figure 2],[Figure 3], and more recently, 3DCT reconstructions. The 3DCT reconstructions may be performed with SSD (surface-shaded display) or VRT (volume rendering technique) methods. VRT is superior to SSD.

Irrespective of the 3D method used, it is possible to disarticulate the femoral head, which then helps in viewing the acetabulum from the lateral aspect.

Anatomy

The acetabulum is made up of the anterior column, which includes the anterior wall, and the posterior column, which includes the posterior wall. The two meet to form the roof. Medially is the thin quadrilateral plate.

Plain radiographs

The frontal projection shows overlapping margins and walls. The obturator Judet view shows the anterior column and posterior wall. The iliac Judet view shows the posterior column and the anterior wall. The inlet view shows the posterior column and medial quadrilateral plate. The outlet view shows part of the anterior column.

CT

On plain axial CT, the anterior and posterior walls and columns are visualized well. The medial quadrilateral plate and roof are also well depicted. Sagittal and coronal reconstructions show various parts of the acetabulum well. 3DCT reconstructions show different parts of the anatomy the best. The acetabular fossa is best visualized in the lateral view.

Associated Abnormalities

During evaluation of the acetabulum, it is also necessary to evaluate the adjacent bones and joints for associated trauma.

a.Acetabular fractures are often associated with pelvic injuries. On plain radiographs and CT, a search for fractures of the sacrum, ilium, pubis and ischium should be performed. The SI joints and pubic symphysis must be examined in detail.

b. Fracture head and neck femur

c.Intra-articular bone fragments[2]

 
   References Top

1.Potok PS, Hopper KD, Umlauf MJ. Fractures of the acetabulum: imaging, classification, and understanding. Radiographics 1995; 15:7-23.  Back to cited text no. 1    
2.Brandser E, Marsh JL. Acetabular fractures: easier classification with a systematic approach. Am J Roentgenol 1998; 171:1217-28.  Back to cited text no. 2    

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Correspondence Address:
B Jankharia
Imaging Centre, Bhaveshwar Vihar, 383, Sardar V P Rd, Mumbai 400 004
India
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Source of Support: None, Conflict of Interest: None


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    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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