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Citation, DOI & article dataCitation: Murphy, A., Bell, D. Hip (Clements-Nakayama view). Reference article, Radiopaedia.org. (accessed on 23 Oct 2022) https://doi.org/10.53347/rID-53099 The Clements-Nakayama view of the hip is a highly specialized lateral projection utilized on patients with bilateral femoral fractures, or patients unable to mobilize due to postoperative requirements. When performed correctly the projection can yield images of a high diagnostic quality comparable to the horizontal beam lateral hip. This projection can also be utilized to image the femoral shaft in the setting of bilateral femoral fractures (see figure 1). On this page:The projection was first described in 1980 as a method to image patients after total hip arthroplasty 1 however it can be utilized in most scenarios where a lateral view of the hip and the patient is unable to move.
The radiograph has a uniform exposure throughout, evident by the fine bony detail and no areas of overexposure. If the distal femur is overexposed, then a filter may be required. The lesser trochanter can be seen in profile, while the proximal femoral shaft superimposes the greater trochanter. The femoral neck is central to the image and shows no signs of radiographic foreshortening or elongation. There is a clear visualization of the articular surface of the acetabulum and the head of the proximal femur. This is one of the harder projections in trauma imaging to master, it is used infrequently and requires a higher level of skill than standard hip views. Something to consider when setting up for a Clements-Nakayama view is the patient's soft tissue volume, patients with a higher proportion require a steeper posterior angle to clear the other leg. The posterior angle is necessary to achieve a true lateral hip, however, be wary of any metal on the table that may project onto the image. This is why the patient should be as close as safely possible to the edge of the table closest to the detector. The best way to approach the examination would be to consider this projection similar to a shoot through the hip, however, you are angling down rather than raising the leg. Quiz questionsReferencesRelated articles: Imaging in practicePromoted articles (advertising)focusNode Didn't know it? Knew it? Embed Code - If you would like this activity on your web page, copy the script below and paste it into
your web page. SJC Zerbe Procedures Semester 2 Unit 1
How should the central ray be directed to the Lauenstein method of the lateral hip projection?Central ray Perpendicular through hip joint, located midway between ASIS and pubic symphysis for Lauenstein method and at a cephalic angle of 20-25 degrees for Hickey method.
How is the central ray directed for an AP projection of the hip?The central ray should be directed perpendicular to the plane of the film and enter approximately 2.5 in. (6.4 cm) distal on a line drawn perpendicular to the midpoint of a line between the anterior superior iliac spine and the symphysis pubis.
Which method demonstrates the hip in an Axiolateral projection?Positioning chpt7. |