Acetabular protrusio and pelvic tilt

Case contributed by Dr Patsy Robertson

Presentation

Clinical DDH

Patient Data

Age: 16
Gender: Female

Pelvis and Bilateral Hip X-ray

No imaging is available for comparison.

Mild coxa valga deformity of bilateral femora is demonstrated with mild coxa magna. There is mild protrusio, the inner margin of the acetabulum passing deep to the ilioischial line. Apparent crossover sign of the acetabulum bilaterally is likely due to pelvic tilt since the distance between the symphysis pubis and coccyx is greater than 3 cm. Lucency at the junction of the right femoral head and neck laterally may be secondary to impaction (impingement). 

Case Discussion

Apparent acetabular retroversion occurs when there is pelvic tilt. AP pelvic film should be taken with a film-tube distance of 1.2 m. Distance between the tip of the coccyx and symphysis pubis should be between 1 and 3 cm. I this case it is greater than 3 cm indicating pelvic tilt. This causes apparent cross over between the anterior and posterior margins of the acetabulum.

In this case the medial margin of the acetabulum passes medial to the ilio-ischial line although the centre edge angle is normal indicating mild protrusio.

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Case information

rID: 30583
Case created: 20th Aug 2014
Last edited: 22nd Jul 2017
Inclusion in quiz mode: Included

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