Pediatric hip (abduction-internal rotation view)
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The von Rosen view is used in the diagnosis of developmental dysplasia of the hip in pediatric patients. This view forces dislocation of the affected hip(s) by abducting the leg to 45 degrees, hip the same principle used in the Ortolani test 1.
patient is supine
the patient's legs are forcibly abducted to a minimum of 45 degrees
the femora are internally rotated 1
midway between the anterior superior iliac spine and the pubic symphysis
superior to the iliac crest
inferior to the proximal third of the femur
lateral to the skin margins
variable based upon pediatric patient size
Image technical 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
subluxed hips will relocate however, fully dislocated hips will not relocate
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 pediatric but may be performed in the evaluation of the adult pelvis.