Presentation
Fall from a 3-metre height. Right hip pain.
Patient Data
The right iliopectineal line is disrupted, indicating a fracture of the anterior acetabular column.
(See annotated image below)
The iliopectinal line is drawn bilaterally.
On the right, the line drawn in red is interrupted, a sign of pelvic ring fractures which may be present in acetabular fractures and superior pubic rami fractures, for example.
On the left, the line drawn in green is uninterrupted.
Case Discussion
Acetabular fractures are a subgroup of pelvic fractures. Pelvic fractures are related to pelvic trauma with a risk of grave haemorrhage. If a pelvic fracture is suspected, proper physical examination and radiographic studies are extremely important.
The initial radiograph performed on this case identified a pelvic ring fracture as noted by the abnormal right iliopectineal line.
A CT was performed, which further revealed right superior and inferior pubic rami fractures.
Initial radiograph imaging may underestimate pelvic ring fractures, in order to improve identification of possible fractures, it is often useful to assess the following lines to check for abnormalities:
iliopectineal line
ilioischial line
teardrop
roof of acetabulum
edge of the anterior acetabular wall
edge of the posterior acetabular wall
Shenton line
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