AP radiograph of the pelvis, summarising the lines to review when excluding subtle fractures: sacral arcuate lines, iliopectineal line (sciatic notch, along superior pubic ramus to symphysis pubis), ilioischial line (sciatic notch to medial border of the ischium) and Shenton’s line (medial edge of the femoral neck and the inferior edge of the superior pubic ramus).
AP radiograph of pelvis and right hip showing fracture of the right superior ischial spine (arrow) and subtle fracture of the acetabulum (curved arrow). The patient presented with hip pain post fall.
Examination notes
What are the common fracture patterns in the pelvis?
Acetabular and pubic rami (inferior or superior)
Sacral and sacroiliac joint
Apophysis avulsion fractures
A fracture at any site in the pelvic ring is associated with a second fracture (double fractures are inherently unstable).
If no second fracture seen, look for apophysis avulsion fractures or disruption (widening or diastasis) of joints (e.g. symphysis pubis and sacroiliac joint).
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
