Pelvis/Hip Case 4 Diagnosis
Acetabular fracture (disruption of iliopectineal line)
The AP pelvis film usually initially diagnoses these fractures. Structures that can be disrupted in acetabular fractures are:
the ilieopectineal line (anterior column)
ilioischial line(posterior column)
the acetabular teardrop
the obturator foramen (see figure).
Iliac wing fracture is often an indication of associated acetabulum fracture.
Once diagnosed, these fractures are further characterized by oblique (Judet) views of the pelvis and CT scanning for more precise staging.
Acetabular landmarks in the patient from the case:
Normal left iliopectineal line (blue arrows), the right has a disruption (pink arrow) and is abnormal
Normal left ilioischial line (black arrows) normally bisecting the acetabular teardrop (red arrows); but the right ilioischial line is abnormal: it falls outside the teardrop and disrupts proximal to the ischium (white arrow), signifying fracture displacement.