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X-ray of the pelvic bones is a fast and at the same time reliable option for diagnosing the bone structure of this area. In addition to studying the state of the immediate pelvic ring, the procedure allows you to find out if the internal organs and the soft tissues surrounding them have been significantly damaged.
If you use an additional stage of contrasting, then at the same time it will be possible to identify possible retroperitoneal hematomas, which are unlikely to be detected with the naked eye.
Features of the technique and its essence
X-ray of the classical type works equally for all parts of the human body, so the pelvic circle is no exception. Unlike magnetic resonance imaging or computed tomography, x-rays are more focused on obtaining information about state of the bone structure. Due to the change in the percentage of stiffness, other tissues appear in the image, but this is usually not enough to make an accurate diagnosis. Patients are sent for CT or MRI.
And here is that concerns bone imaging, it’s her excellent for diagnosing pathology of this body tissues. Against the background of modern methods of studying internal organs and parts body, this diagnostic is in consistently high demand due to its relative cheapness and ease of implementation. Therefore, if nagent there are suspicionsis on the most common pathologies of the pelvic bones, it is much more profitable for the wallet to use x-rays.
Especially this method will be a successful diagnostic option if the examination is on digital apparatus. It irradiates a person with a lower dosage of radioactive rays, which has a positive effect on overall well-being. Digital search apparatus has a number of other positive aspects, among which the ability to instantly withdraw the received снимок on the computer screen.
Received information along with conclusion doctor-radiologist can be recorded on digital media. But if information is required on hand, then x-raythe laboratory assistant can print the picture on film, and along with the description, made by a radiologist, will provide the attending physician.
Most often, surgeons, orthopedists or traumatologists send for examination. Moreover, it is not at all necessary that the reason for the referral was the suspicion of a fracture of the closed or open type. There are many other abnormalities concerning both the pelvic bones themselves and the hip joints. The state of the latter is checked using radiography in identical positions and projections as the bones. This allows you to get a detailed picture of the clinical situation in one image, which helps to establish the degree of damage.
Besides a picture can give information about the specific location of the lesion, perhaps even degrees disease, spread pathologicallyth process into neighboring zones. Such an integrated approach is especially important ifagent there is suspicion of neoplasm. Using black and whiteth picture can be find out if there are metastases in neighboring tissues, or process only at the initial stage of development.
But exactly and credibly to figure out whether the found tumor is benign or malignant, other tests will help histochemical analysis of the material taken during a biopsy, or the entire tumor removed during surgery.
Since one image able to give assessment of several structures and tissues at once study area, these possibilities are used not only to identify a problem point. Based on the results obtained, the attending physician will decide which treatment format is ideal for this particular patient. This is about surgical intervention, or about alternative version – conservative treatment with the use of medications and other means..
In the first case, the resulting picture will become a kind of map of the state of the pelvic region inside, which will allow you to calculate the risks and the percentage of successful outcome of the operation. Upon its completion the patient may need periodically undergo a re-examination of this kind. This is necessary to monitor the dynamics of recovery. If no positive changes are found at the designated time, then this is a reason to revise the previously approved therapy program. Even after osteosynthesis, regular checks are indispensable in order to evaluate the current successful union.tion fragments brought together.
Other indications for radiography cover the following aspects:
- damage to the iliosacral and pubicdivisions;
- fractures of the neck, head, proximal femur;
- pathologistand joints like arthritis and arthrosis;
- dislocations;
- subluxations, including congenital;
- osteochondropathy of the femoral head;
- osteoporosis;
- tumors of any etiology.
Sometimes research is indispensable when it is necessary to confirm rare hereditary or acquired diseases.
Preparatory stage
Preparation is not particularly difficult It has. From pagent required just two days before the appointed date Survey stick to certain diets. It provides for the rejection of foods that stimulate increased gas formation:
- cabbage;
- legumes;
- black bread;
- dairy.
Because of them visualization of area structures the pelvis decreases by an order of magnitude, which can cause need re-examination, once again irradiating organism. What if illness or pathology are at an early stage of development, it is unlikely that they will be considered at all due to increased gas formation.
Exception to rule training are patients who are urgently admitted to the hospital department. Doctor on site takes decision, in case obtaining a blurry and uninformative picture about the choice of further diagnostics.
If the examination is planned, then you will need to stop eating twelve hours before the start of the procedure. The day before, it does not hurt to do a cleansing enema in order to better prepare the study area for visualization during the study.
An alternative may be the use of special pharmacy products that are freely available. Their cleansing effect is identical.
Another important preparation point will warning the doctor about whether the patient has built-in electronic mechanisms in the body. We are talking about built-in hearing aids, pacemakers and other similar devices that can fail if this study. Moreover, their location does not play a significant role.
But the presence of metal inserts, such as support spokes, pins or staples after предыдущих fractures, does not pose a serious threat, including in terms of information content of the study. It is enough just to warn about such a feature in advance. radiologist and physician.
Also directly before examination, you will need to remove metal jewelry and other removable metal elements that can limit informational content or clarity received image.
Having figured out how to prepare, it remains only not to forget about two important contraindications:
- pregnancy;
- childhood.
The first point concerns women who are on any gestation period. Despite the fact that for adults the device gives a radiation exposure within the officially allowable dose, for the fetus it can be impetus to the appearance of developmental anomalies. This is about violations in mental or physical development. Usually for pregnant women choose study the condition of the pelvis using a more gentle examination format – ultrasound, or MRI diagnostics, starting from the second trimester of pregnancy.
Almost the same concerns the situation with children under the age of fifteen. But here the contraindication applies to discharge relative. In practice, this means that when the benefit from research over the possible harm without x-rays is still indispensable.
To reduce radiation exposure to the rest of the body, используются special lead aprons. They are designed to protect the thyroid gland from excessive stress, because it is this organ that is considered the most sensitive to impact radioactive irradiation.
Standard radiation rate at survey the pelvis ranges from 1,57-2,23 mSv. The exact figure depends on the number of projections needed to establish the diagnosis, as well as the date of issue of the device itself. The older he is, the more unnecessary radiation he will give out.
Scheme of the
The standard diagnostics с using x-rays is considered a direct projection, which is also called anterior-posterior. It provides for the location of the patient strictly horizontally. Moreover, even a careless shift to the side threatens to distort diagnostic result.
Care should also be taken to ensure that during receiving photo pagent lay completely still because from this its clarity will depend. Traditional styling patient for direct projection provides the following features:
- horizontal position;
- elongated legs that are 12 degrees turned to the inside;
- lining of a special roller under the knees;
- elbows on the sides;
- brushes on the chest.
An alternative to positioning the upper limbs is to simply extend them along the body. But if you suspect a fracture or dislocation of the pelvisth bones, turning the lower limbs inward is not worth it, as the risk of aggravating the already painful well-being of the patient increases.
The diagnostic result will be symmetrical image covering both halves of the pelvis. It will look good on:
- sacrum;
- branches of the pubic bones;
- branches of the ischial bones.
It turns out good to see the substance of the bone structure, as well as the boundaries of the acetabulum, neck femoral bones. Usually, the information obtained is sufficient to identify pathological deviations. But if u physician questions remain, the patient can send again to the office for the diagnosis of another projection.
Discover, will need whether to do research several times, you can attentive reading the given direction. If it is indicated there that it is required to use the Lilienfeld modification, then this indicates the need use posterior axial projection for visualization pelvic inlet.
If necessary, to deal with the outlet, you will have to use the Taylor modification. For this, they also use the posterior axial projection.
Sometimes the doctor needs to get an image of the acetabulum to it he resorts to posterior oblique projection. But the modification according to Clements-Nakayama suggests that the patient will be placed in the asio-lateral lower-upper projection. The result will give information about how things are with the hip joint and proximal femur bones.
Posterior oblique necessary in order to visualize better sacroiliac joints. For identical purposes radiologists use conventional posterior axial view.
If the patient is able to independently get to the venue examinationovation, then he is sent straight to the radiography room. But, if he was taken from the scene, suspecting polytrauma, then it will be more effective use portableth apparatus straight to the emergency roomoh ward. This will prevent subjecting the patient extra load and avoid potential complications..
When do children need x-rays?
Since childhood concerns to contraindications to x-ray examination, doctors prefer to use more gentle analogues for studying their state pelvis. This is especially true for children whose age has not yet reached four months.
But if you suspect the child hip dislocation, which maybe congenital defect, it is rather problematic to do without X-ray of the pelvis. Adding to the difficulty is the fact that such a pathology joint observed with only one side.
To be sure of their suspicions, babies who have crossed the line of four months are prescribed an x-ray. But newborns will still have to do with ultrasound.
correctly interpret received survey results only an experienced child can orthopedistwhich will take everything into account features of the child’s body. The rule applies to the acetabulum and heads femoral boneswhich are cartilagefabric. Their contrasting shadows cannot be detected in the image.
If baby the smoothness of the articular cavity was found, this indicates a maturingth pathology. Also, a black and white image will allow you to see if there are examined child ossification nuclei in the femur.
Subluxation will be indicated notcomplete head closure femur acetabulum, which is easy to see on pictures good quality. About complete dislocation will testify slightly different picture will show not only the smoothness of the articular cavity. If the head is smaller on one side, or compacted in the same place, located outside the cavity, these are alarming signs.
With received snapshot parents need to handle to experienced pediatric orthopedistto undergo other examinations and work out tactics baby treatment.