Paediatric hip (abduction-internal rotation view)

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The von Rosen viewview is a radiographic projection of the hip that demonstrates the relationship between the femoral head and the acetabulum.

The von Rosen view is used in the diagnosis of developmental dysplasia of the hip (DDH) in paediatric patients. This view forces dislocation of the affected hip(s) by abducting the leg to 45 degrees, the same principle used in the Ortolani test 1. 

Patient Position

  • patient is supine
  • the patient's legs are forcibly abducted to a minimum of 45 degrees
  • the femora are internally rotated 1

Technical Factors

  • AP projection
    • centering point
    • centering point

      • midway between anterior superior iliac spine and the pubic symphysis

    • collimation

      • superior to the iliac crest

      • inferior to the proximal third of the femur

      • lateral to the skin margins
    • orientation

      • : landscape

    • exposure: 

      • variable based upon paediatric patient size

    • SID
      • 100cm
    • grid
      • variable based upon paediatric patient size
    • SID: 100cm
    • grid: variable based upon paediatric patient size

    Image Technical Evaluationtechnical evaluation

    • bony pelvis is demonstrated from the iliac crest to the proximal third of the femur
    • the femur is abducted to at least 45 degrees 
    • obturator foramina are equal and open

    Practical Pointspoints

    The resultant radiograph will demonstrate the relationship between the long axis of the femur and the acetabulum. In a child with normal hips, the long axis of the femur will align with the lateral margin of the acetabulum, indicating that the hip is enlocated. In a child with dysplastic hips, the long axis of the femur will align with the anterior superior iliac spine 2. 

    Abduction of less than 45 degrees may result in a false-positive test 2.

    This projection is primarily paediatric but may be performed in the evaluation of the adult pelvis.

  • -<p>The <strong>von Rosen </strong>view is a radiographic projection of the hip that demonstrates the relationship between the femoral head and the acetabulum.</p><p>The von Rosen view is used in the diagnosis of <a href="/articles/developmental-dysplasia-of-the-hip">developmental dysplasia of the hip</a> (DDH) in paediatric patients. This view forces dislocation of the affected hip(s) by abducting the leg to 45 degrees, the same principle used in the Ortolani test <sup>1</sup>. </p><h4>Patient Position</h4><ul>
  • +<p>The <strong>von Rosen view</strong> is a radiographic projection of the <a title="Hip joint" href="/articles/hip-joint-1">hip</a> that demonstrates the relationship between the femoral head and the <a title="Acetabulum" href="/articles/acetabulum">acetabulum</a>.</p><p>The von Rosen view is used in the diagnosis of <a href="/articles/developmental-dysplasia-of-the-hip">developmental dysplasia of the hip</a> in paediatric patients. This view forces dislocation of the affected hip(s) by abducting the leg to 45 degrees, the same principle used in the Ortolani test <sup>1</sup>. </p><h4>Patient Position</h4><ul>
  • -<li><h6>AP projection</h6></li>
  • -<h6>centering point</h6>
  • -<ul><li><p>midway between anterior superior iliac spine and the pubic symphysis</p></li></ul>
  • +<strong>AP projection</strong><ul>
  • +<li>centering point</li>
  • +<li>midway between anterior superior iliac spine and the pubic symphysis</li>
  • +</ul>
  • -<h6>collimation</h6>
  • -<ul>
  • -<li><p>superior to the iliac crest</p></li>
  • -<li><p>inferior to the proximal third of the femur</p></li>
  • +<strong>collimation</strong><ul>
  • +<li>superior to the iliac crest</li>
  • +<li>inferior to the proximal third of the femur</li>
  • -<h6>orientation</h6>
  • -<ul><li><p>landscape</p></li></ul>
  • -</li>
  • +<strong>orientation</strong>: landscape</li>
  • -<h6><strong>exposure</strong></h6>
  • -<ul><li><p>variable based upon paediatric patient size</p></li></ul>
  • -</li>
  • +<strong>exposure: </strong>variable based upon paediatric patient size</li>
  • -<h6>SID</h6>
  • -<ul><li>100cm</li></ul>
  • -</li>
  • +<strong>SID: </strong>100cm</li>
  • -<h6>grid</h6>
  • -<ul><li>variable based upon paediatric patient size</li></ul>
  • -</li>
  • -</ul><h4>Image Technical Evaluation</h4><ul>
  • +<strong>grid</strong>: variable based upon paediatric patient size</li>
  • +</ul><h4>Image technical evaluation</h4><ul>
  • -<li>the femur is abducted to <em>at least</em> 45 degrees </li>
  • +<li>the femur is abducted to at least 45 degrees </li>
  • -</ul><h4>Practical Points</h4><p>The resultant radiograph will demonstrate the relationship between the long axis of the femur and the acetabulum. In a child with normal hips, the long axis of the femur will align with the lateral margin of the acetabulum, indicating that the hip is enlocated. In a child with dysplastic hips, the long axis of the femur will align with the anterior superior iliac spine <sup>2</sup>. </p><p>Abduction of less than 45 degrees may result in a false-positive test <sup>2</sup>.</p><p>This projection is primarily paediatric but may be performed in evaluation of the adult pelvis.</p><p> </p>
  • +</ul><h4>Practical points</h4><p>The resultant radiograph will demonstrate the relationship between the long axis of the femur and the acetabulum. In a child with normal hips, the long axis of the femur will align with the lateral margin of the acetabulum, indicating that the hip is <a title="Enlocated" href="/articles/enlocated">enlocated</a>. In a child with dysplastic hips, the long axis of the femur will align with the anterior superior iliac spine <sup>2</sup>. </p><p>Abduction of less than 45 degrees may result in a false-positive test <sup>2</sup>.</p><p>This projection is primarily paediatric but may be performed in the evaluation of the adult pelvis.</p>

References changed:

  • 1. Andren, L. and Von Rosen, S., 1958. The diagnosis of dislocation of the hip in newborns and the primary results of immediate treatment. Acta radiologica, (2), pp.89-95.
  • 2. von Rosen, S., 1962. Diagnosis and treatment of congenital dislocation of the hip joint in the new-born. The Journal of Bone and Joint Surgery. British volume, 44(2), pp.284-291.
  • 1. Andren, L. and Von Rosen, S., 1958. The diagnosis of dislocation of the hip in newborns and the primary results of immediate treatment. Acta radiologica, (2), pp.89-95. 2. von Rosen, S., 1962. Diagnosis and treatment of congenital dislocation of the hip joint in the new-born. The Journal of Bone and Joint Surgery. British volume, 44(2), pp.284-291.

Tags changed:

  • cases

Systems changed:

  • Musculoskeletal

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