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The Bristol Hip View: a new hypothetical radiographic projection for femoral neck fractures

Department of Radiology, Southmead Hospital, North Bristol Trust, Westbury on Trym, Bristol BS10 5NB, UK

View larger version (58K): [in a new window]   Figure 1. Diagrammatic representation of the typical beam incident angles for a routine anteroposterior(AP) pelvis (70° to femoral neck), AP hip, (75° to femoral neck), beam angle of 15° (90° to femoral neck), and 30° beam angle (105° to femoral neck).

View larger version (115K): [in a new window]   Figure 2. (a) Film of femoral neck obtained using a 15° angled beam. (b) Film of femoral neck simulating an anteroposterior (AP) hip. (c) Film of femoral neck obtained using a 30° angled beam. (d) Film of femoral neck obtained simulating an AP pelvis.

View larger version (97K): [in a new window]   Figure 3. (a) Film (Y) of fracture with least sharpness (view equivalent to an anteroposterior (AP) pelvis). (b) Film Z showing the greatest fracture sharpness (30° angulation to the femoral head).

View larger version (13K): [in a new window]   Figure 4. Graphic representation of the radiographs A, B, C, D showing the observers' results by region. This shows increased performance of A and C.

View larger version (10K): [in a new window]   Figure 5. Graphic representation of the fracture sharpness. This shows increased clarity of the fracture in film Z, out performing the traditional views X and Y(p<0.001).