Femur

1. How do you position for an AP upper femur?

a. Leg is internally rotated 5-10 degrees, ASIS is at the top of IR
b. Leg is internally rotated 15-20 degrees, ASIS is at the top of IR
c. Leg is internally rotated 15-20 degrees, crest is at the top of IR
d. Leg is internally rotated 5-10 degrees, crest is at the top of IR
2. How are the trochanters positioned for the AP upper femur?
a. Greater trochanter in profile, lesser trochanter is not in profile
b. Lesser trochanter in profile, greater trochanter is not in profile
c. Both trochanters are not in profile
d. Both trochanters are in profile
3. How should you position the IR for the lower AP femur?
a. Lower edge should be 2” below the knee joint
b. Lower edge should be 1” below the knee joint
c. Lower edge should be at knee joint level
d. Lower edge should be at apex patel level
4. If the patient was excessively rotated on a lateral distal femur, what would the
projection look like?
a. Medial condyle is more anterior than the lateral condyle, fibular head is
superimposed over tibia
b. Medial condyle is more anterior than the lateral condyle, no
superimposition of fibular head
c. Lateral condyle is more anterior than the lateral condyle, no
superimposition of fibular head
d. Lateral condyle is more anterior than the lateral condyle, fibular head is
superimposed over tibia
5. If the patient was insufficiently rotated on a lateral distal femur, what would the
projection look like?
a. Medial condyle is more anterior than the lateral condyle, fibular head is
superimposed over tibia
b. Medial condyle is more anterior than the lateral condyle, no
superimposition of fibular head
c. Lateral condyle is more anterior than the lateral condyle, no
superimposition of fibular head
d. Lateral condyle is more anterior than the lateral condyle, fibular head is
superimposed over tibia
6. How is the patient positioned in the lateral distal femur and how should the
technologist improve this image?
 a. Patient is rotated excessively, rotate the body to the left
b. Patient is rotated excessively, rotate the body to the right
c. Patient is rotated insufficiently, rotate the body to the left
d. Patient is rotated insufficiently, rotate the body to the right
7. What is B in this image below?

a. Lesser trochanter
b. Femoral neck
c. Femoral head
d. Greater trochanter
8. How is the patient positioned in the image in question #7?
a. Leg is excessively rotated laterally
 b. Leg is excessively rotated medially
c. Leg is abducted excessively
d. Body is rotated toward the left excessively
9. If a lateral proximal femur shows the lesser and greater trochanter in profile,
what should the technologist do on the repeat?
a. Rotate leg laterally
b. Rotate leg medially
c. Flex leg
d. Extend leg
10. How is the patient positioned for this lateral proximal femur?

a. Excessively flexed
b. Insufficiently flexed
c. Excessively rotated
d. Insufficiently rotated
11. How is the patient positioned in the distal lateral femur projection below?
 a. Patella is too close to the IR
b. Patella is too far away from the IR
c. Knee is excessively flexed
d. Knee is insufficiently flexed
12. A lateral distal femur shows the fibular head fully superimposed by the tibia.
What should the technologist do on the repeat?
a. Move patella closer to the IR
b. Move patella away from the IR
c. Increase CR cephalically
d. Increase CR caudally
13. If a lateral distal femur projection shows medial condyle anterior to the lateral
condyle. How should the technologist improve the image?
a. Move patella away from the IR
b. Move patella close to the IR
c. Bring CR cephalically
d. Bring CR caudally
14. All distal femur projections the condyles not aligned with each other due to the
divergent beam, which one of the condyles are the medial and lateral
condyle?
a. Distal condyle = lateral condyle, superior condyle = medial condyle
b. Distal condyle = medial condyle, superior condyle = lateral condyle
15. A lateral distal femur projection shows the tib-fib joint in profile. Should the
technologist do a repeat?
a. No, but it would be better if the patella was closer to the IR
b. No, but it would be better if the patella wasn’t so close to the IR
c. Yes, rotate leg so patella is closer to the IR
d. Yes, rotate leg so patella is away from the IR
16. What’s the technique factor the femur projections?
a. 50-55kV, 4mAs
 b. 55-65kV, 5mAs
c. 70-80kV, 10mAs
d. 80-85kV, 5mAs

Hips
1. Which 2 bony landmarks need to be palpated for hip localization?
a. Crest, ASIS
b. Crest, symphysis pubis
c. ASIS, symphysis pubis
d. ASIS, greater trochanter
2. Where is the femoral neck located?
a. 2 ½” inferior to midway between ASIS and symphysis pubis
b. 1” inferior to ASIS
c. 2” inferior to ASIS
d. 3-4” inferior to iliac crest
3. Which physical sign may indicate that a patient has a hip fracture?
a. Crippled heads and arms
b. Non-comprehensive
c. Internally rotated leg
d. Externally rotated leg
4. Which projection should be taken first and reviewed by a radiologist before
attempting to rotate the hip into a lateral position if a trauma is suspected?
a. Lateral c-spine
b. Lateral hip
c. AP pelvis
d. Axiolateral hip
5. Gonadal shielding should be used for all patients of reproductive age, unless
____________________.
a. Patient has a fracture
b. The lead obscures the ROI
c. Patient is over 60yrs old
d. Patient is over 30 yrs old
6. Should a gonadal shield be used for a hip study on a young female? Please
explain and how.
a. No, it will obscure the ROI
b. No, it’s not necessary
c. Yes, place the ovarian shield with the top at the ASIS level
d. Yes, place the ovarian shield with the top at the iliac crest
7. How should a gonadal shield be used on a male patient?
a. Corner of shield within gonadal area
b. A side of shield within gonadal area
c. No shield is necessary
 d. None of the above
8. What’s the advantage of using 90kV rather than 80kV range for hip and pelvic
studies on younger patients?
a. More dose
b. Less dose
c. Enhances contrast, less dose
d. Enhances brightness, less dose
9. What’s the disadvantage of using 90kV for hip and pelvis studies, especially
on older patients with some bone mass loss?
a. More dose
b. Less dose
c. Decrease in contrast
d. Increase in contrast
10. What’s the centering point for the AP hip?
a. 1-2” medial and 3-4” distal to ASIS
b. 3-4” medial and 1-2” distal to ASIS
c. 1-2” lateral and 3-4” superior to ASIS
d. 3-4” lateral and 1-2” superior to ASIS
11. How do you position for the AP hips?
a. Externally rotate legs 5-10 degrees
b. Externally rotate legs 15-20 degrees
c. Internally rotate legs 5-10 degrees
d. Internally rotate legs 15-20 degrees
12. How are the trochanters positioned for the AP hips?
a. Lesser trochanter is in profile
b. Greater trochanter is in profile
c. Lesser and greater trochanters are in profile
d. Both trochanters are not in profile
13. Label the anatomy in the image below.
 a. A: pelvic brim, B: ischial spine
b. A: ischial spine, B: pelvic brim
c. A: superior ramus, B: pelvic brim
d. A: inferior ramus, B: pelvic brim
14. How are the ischial spine and pelvic brim positioned for the AP hip?
a. Both are aligned with each other
b. Ischial spine is medial to pelvic brim
c. Pelvic brim is medial to ischial spine
d. Ischial spine is superior to pelvic brim
15. If the patient was rotated on the affected hip for the AP hip projection, how are
the anatomies aligned?
a. Narrowed Obturator foramen, no superimposition of pelvic brim and
ischial spine
b. Widened obturator foramen, no superimposition of pelvic brim and
ischial spine
c. Narrowed obturator foramen, aligned pelvic brim and ischial spine
d. Widened obturator foramen, aligned pelvic brim and ischial spine
16. If the patient is rotated away from the affected hip, how are the anatomies
aligned?
a. Pelvic brim is not in profile, obturator foramen is narrowed
b. Pelvic brim is not in profile, obturator is widened
c. Ischial spine is not in profile, obturator foramen is widened
d. Ischial spine is not in profile, obturator foramen is narrowed
17. How is the patient positioned in the image below?

a. Patient rotated toward affected hip, leg internally rotated

b. Patient rotated toward affected hip, leg externally rotated
c. Patient rotated away from affected hip, leg externally rotated
d. Patient rotated away from affected hip, leg internally rotated
18. How should the patient be positioned for the repeat on the AP hip projection?
 a. Rotate patient toward affected side
b. Rotate patient toward unaffected side
c. Rotate patient toward affected side, internally rotate leg
d. Rotate patient toward unaffected side, internally rotate leg
19. How should you position for the frog leg hip projection?
a. Legs are 20 degrees abducted
b. Legs are 45 degrees abducted
c. Legs are 60 degrees abducted
d. Legs are 80 degrees abducted
20. How should the femoral shafts be angled or abducted from the table?
a. 20 degree
b. 45 degree
c. 60 degree
d. 80 degree
21. Should the pelvic brim be in profile for the AP bilateral frog leg projection?
a. Yes
b. No
22. How are the trochanters positioned for the AP bilateral frog leg projection?
a. Lesser trochanter in profile
b. Greater trochanter in profile
c. Lesser trochanter in profile w/ greater trochanter in minimal profile
d. Greater trochanter in profile w/ lesser trochanter in minimal profile
23. How are femoral necks positioned in the AP bilateral frog leg projection?
a. Fully foreshortened
b. Partially foreshortened
c. No foreshortening
d. Not in profile
24. What should the technologist do for the repeat on the AP hip frog leg
projection?

a. Decrease the degree of femoral abduction

b. Increase the degree of femoral abduction
c. Decrease the degree of femoral abduction, rotate toward left hip
d. Increase the degree of femoral abduction, rotate toward left hip
25. What positioning error is committed if the greater and lesser trochanter is in
profile posteriorly for frog leg hip projection (angle between the femur and
tube is too large)?
a. Knee and hip flexed more than needed
b. Knee and hip insufficiently
c. Rotation toward the affected hip
d. Rotation toward the unaffected hip
26. How should the axiolateral hip projection be positioned?
a. IR is perpendicular to the CR, with the IR at an angle to the affected
side
b. IR is perpendicular to the CR
c. IR is parallel to the affected femur
d. IR is parallel to the unaffected femur
27. How should the CR be aligned for an axiolateral hip projection?
a. Perpendicular to femoral neck
b. Perpendicular to acetabulum
c. Perpendicular to femoral shaft
d. Perpendicular to less trochanter
28. What happens there’s misalignment of the CR with the femoral neck for the
axiolateral hip, and the CR angle is too large?
a. Greater trochanter is proximal to transverse level of the lesser
trochanter
b. Lesser trochanter is proximal to transverse level of the greater
trochanter
c. Femoral neck is elongated
d. Femoral neck is foreshortened w/ lesser trochanter superimposed over
the neck
29. If the greater trochanter is demonstrated distal to the transverse level of the
lesser trochanter, how is the tube positioned?
 a. CR angle is too small
b. CR angle is too large
c. Leg is internally rotated
d. Leg is externally rotated
30. What positioning error is committed for this axiolateral hip projection?

a. CR angle is too large

b. CR angle is too small
c. Leg is externally rotated
d. Leg is internally rotated
31. If the greater trochanter is shown posterior to the femoral neck with lesser
trochanter superimposed, how is the leg positioned for the axiolateral hip?
a. Leg is internally rotated
b. Leg is abducted excessively
c. Unaffected leg is flexed enough
d. Leg is externally rotated
32. How should the technologist improve this image for the repeat?

a. Internally rotate affected leg, flex and abduct the unaffected leg
b. Externally rotate affected leg, flex and abduct the unaffected leg
c. Internally rotate affected leg, extend and adduct the unaffected leg
d. Externally rotate affected leg, extend and adduct the unaffected leg
33. How are the trochanters positioned for the axiolateral hip projection?
a. Greater trochanter is anterior, lesser trochanter is posterior to femoral
shaft
b. Lesser trochanter is posterior, greater trochanter is posterior to femoral
shaft
c. Greater trochanter is posterior, lesser trochanter is superimposed over
femoral neck
d. Lesser trochanter is posterior, greater trochanter is superimposed over
femoral neck

Pelvis
1. Which one of the following conditions is a common clinical indication for
performing pelvic and hip examinations on a pediatric patient?
a. Osteoporosis
b. Developmental dysplasia of hip
c. Ankylosing spondylitis
d. Osteoarthritis
2. T/F: Geriatric patients are more prone to hip fractures because of their
increased incidence of osteoporosis
a. True
b. False
3. Which one of the following imaging modalities can be used on a newborn to
assess hip joint stability during movement of the lower limbs?
a. Sonography
b. CT
c. MRI
d. NucMed
4. Which one of the following imaging modalities is most sensitive in diagnosing
early signs of metastatic carcinoma of the pelvis?
a. Sonography
b. CT
c. MRI
d. NucMed
5. Match each of the following pathologic indications to the correct definition
a. A degenerative joint disease 1. Metastatic carcinoma
b. Most common fracture in older 2. Ankylosing spondylitis
patients because of high 3. Congenital dislocation
incidence of osteoporosis or 4. Chondrosarcoma
avascular necrosis 5. Proximal hip fracture
c. A malignant tumor of the cartilage 6. Pelvic ring fracture
of hip 7. osteoarthritis
d. A disease producing extensive
 calcification of the longitudinal
ligament of the spinal column
e. A fracture resulting from a severe
blow to one side of the pelvis
f. Malignancy spread to bone via
the circulatory and lymphatic
systems or direct invasion
g. Now referred to as
developmental dysplasia of the
hip

6. Which of the following devices will improve overall visibility of the proximal hip
demonstrated on an axiolateral projection?
a. Small focal spot
b. 6:1 grid
c. Compensating filter
d. Shadow shield
7. Which of the following modalities will best demonstrate a possible pelvic ring
fracture?
a. CT
b. NucMed
c. MRI
d. Sonography
8. T/F: Both joints must be included on an AP and lateral projection of the femur
even if a fracture of the proximal femur is evident.
a. True
b. False
9. Which ionization chamber(s) should be activated when using automatic
exposure control for an AP pelvis projection?
a. Center chamber only
b. Upper right and left chamber
c. Center and upper left or right chambers
d. Upper left chamber only
10. Which specific positioning error is present when the left iliac wing is elongated
on an AP pelvis radiograph?
a. Rotation toward left
b. Rotation toward right
c. Increased CR angle (cephalad)
d. Increased CR angle (caudad)
11. Which specific positioning error is present when the left obturator foramen is
more open than the right obturator foramen on an AP pelvis projection?
a. Rotation toward left
b. Rotation toward right
c. Increased CR angle (cephalad)
 d. Increased CR angle (caudad)
12. When gonadal shielding is not used, ______ (male or female) receive a
greater gonadal dose with an AP pelvis projection
a. Female
b. Male
13. How many degrees are the femurs abducted (from the vertical plane) for the
bilateral frog-leg projection?
a. 20
b. 30
c. 45
d. 60
14. Where is the central ray placed for a unilateral frog-leg projection?
a. Femoral neck
b. Iliac crest
c. ASIS
d. Lesser trochanter
15. Where is the central ray placed for an AP bilateral frog-leg projection?
a. 1” superior to ASIS
b. 2” superior to ASIS
c. 1” inferior to greater trochanter
d. 1” inferior to iliac crest
16. Which type of pathologic feature is best demonstrated with the Judet method?
a. Acetabular fractures
b. Anterior pelvic bone fractures
c. Proximal femur fractures
d. Femoral neck fractures
17. How much obliquity of the body is required for the Judet method?
a. None
b. 20
c. 30
d. 45
18. T/F: Any orthopedic device or appliance of the hip should be seen in it entirety
on an AP hip radiograph?
a. True
b. False
19. Which one of the following factors does not apply to an axiolateral projection
of the hip on a male patient?
a. Cassette parallel to femoral neck
b. 80-90kV
c. Use of gonadal shielding
d. Use of a stationary grid
20. If patient cannot flex/abduct/ raise unaffected leg out of the way for the
axiolateral projection, what can the technologist do to get the projection?
a. Bring patient back to ER
 b. Talk with the radiologist before taking the projection
c. CR angle is 15-20 degrees posteriorly w/ IR tilted 15 degrees from
vertical, so the CR angle is perpendicular to the IR
d. CR angle is 45 degrees posteriorly w/ IR tilted 45 degrees from vertical,
so the CR angle is perpendicular to the IR
21. Which special projection of the hip demonstrates the anterior and posterior
rims of the acetabulum and the ilioischial and iliopubic columns?
a. AP outlet axial
b. AP inlet axial
c. AP oblique acetabulum
d. Posterior oblique acetabulum
22. This projection is used to assess trauma to pubic and ischial structures?
a. AP outlet axial
b. AP inlet axial
c. Posterior oblique acetabulum
d. AP pelvis
23. What is the optimal amount of hip abduction applied for the unilateral “frog-
leg” projection to demonstrate the femoral neck without distortion?
a. 45 from vertical
b. 90 from vertical
c. 10 from vertical
d. 20-30 from vertical
24. T/F: The lateral projection of the hip or femur will show the femoral neck
foreshortened
a. True
b. False
25. Where’s the CR for the AP pelvis?
a. 1” inferior to ASIS
b. 2” inferior to ASIS
c. 3” inferior to ASIS
d. 4” inferior to ASIS
26. What’s in profile for the AP pelvis?
a. Greater trochanters, ASIS, symphysis pubis
b. Greater trochanters, ala, crest of pelvis, symphysis pubis
c. Lesser trochanters, ala, crest of pelvis, symphysis pubis
d. Lesser trochanters, ASIS, symphysis pubis
27. The AP pelvis projection shows the right obturator foramen narrowed. What
can be improved for the repeat?
a. No repeat necessary
b. Increase rotation toward the left hip
c. Increase rotation toward the right hip
d. None of the above
28. How is the patient positioned in the image below and which way does the
patient need to rotate in order to improve this AP pelvis projection?
 a. RPO, rotate left
b. RPO, rotate right
c. LPO, rotate left
d. LPO, rotate right
29. The technologist decides to use a 40 degree CR angle caudally for the pelvis.
Why did the technologist decide to make this decision after taking the AP
pelvis projection?
a. Doctor wanted to see the ischium and pubis
b. Doctor wanted to see if there was anterior dislocation
c. Doctor wanted to see if there was posterior dislocation
d. Doctor wanted to see the obturator foramen
30. Where’s the CR for AP axial (inlet) pelvis projection?
a. Crest level
b. 1” inferior to crest
c. 2” inferior to ASIS
d. ASIS level
31. How should you position for a AP axial (inlet) pelvis projection?
a. CR angle: 40 caudal, CR: ASIS level
b. CR angle: 20 caudal, CR: ASIS level
c. CR angle: 40 caudal, CR: 2” inferior to crest
d. CR angle: 20 angle, CR: 2” inferior to crest
32. The doctor wants to assess for the female patient’s ischium and pubis. How
should the technologist position for the patient for this projection?
a. CR: 30-45 cephalad, CR: ASIS level
b. CR: 20-35 cephalad, CR: ASIS level
c. CR: 20-35 cephalad, CR: 1-2” distal to symphysis pubis/greater
trochanters
d. CR: 30-45 cephalad, CR: 1-2” distal to symphysis pubis/greater
trochanters
33. For what pelvis projection does the technologist need to prepare for if the
doctor wants to visualize a male patient’s anterior and posterior portion of the
pelvic inlet, along with the posterior displacement of the pelvis?
a. AP axial outlet (30-45 degree)
b. AP axial outlet (20-35 degree)
 c. AP axial inlet (40 degree)
d. AP axial inlet (20 degree)
34. For what pelvis projection does the technologist need to prepare for if the
doctor wants to visualize a male patient’s ischium and pubis of the pelvis?
a. AP axial outlet (30-45 degree)
b. AP axial outlet (20-35 degree)
c. AP axial inlet (40 degree)
d. AP axial inlet (20 degree)
35. How should you position for a posterior oblique pelvis acetabulum
(downside)?
a. CR: 2” distal to ASIS (downside)
b. CR: 2” distal and 2” medial to ASIS (downside)
c. CR: 2” medial to ASIS (downside)
d. CR: 2: distal and 2” medial to ASIS (upside)
36. How should you position for a posterior oblique pelvis acetabulum (upside)?
a. CR: 2” distal to ASIS (upside)
b. CR: 2” distal and 2” medial to ASIS (downside)
c. CR: 2” medial to ASIS (downside)
d. CR: 2: distal and 2” medial to ASIS (upside)
37. Between the downside vs. upside acetabulum view, which one has an open
obturator foramen?
a. Downside acetabulum-posterior oblique view
b. Upside acetabulum-posterior oblique view
c. Downside acetabulum view
d. Upside acetabulum view
38. A radiograph of an AP pelvis projection reveals that the lesser trochanters are
readily demonstrated on the medial side of the proximal femurs. The patient is
ambulatory but has a history of early osteoarthritis in both hips. Which
positioning modification needs to be made to prevent this positioning error?
a. Tape the legs together
b. Leave the patient as he is, there’s a high chance there being a fracture
c. Increase rotation of legs 15-20 degrees medially, patient with general
pain can have their legs rotated safely
d. Increase rotation of legs 15-20 laterally, patient with general pain can
have their legs rotated safely
39. A radiograph of an AP pelvis reveals that the right iliac wing is foreshortened
as compared with the left side. Which specific positioning error has been
made?
a. Patient is in RPO position while right obturator foramen is enlarged
b. Patient is in LPO position while right obturator foramen is enlarged
c. Patient is in RPO position while right obturator foramen is narrowed
d. Patient is in LPO position while right obturator foramen is narrowed
40. A radiograph of an axiolateral projection reveals that the posterior aspect of
the acetabulum and femoral head were cut off of the bottom of the image. The
 emergency room physician requests that the position be repeated. What can
be done to avoid this problem on the repeat exposure for patient on a
stretcher bed?
a. Bring IR and tube closer to the ground
b. Elevate patient by 2” by putting sheet under the patient
c. Bring IR and tube more distal towards the feet
d. Bring IR and tube more superior towards the shoulders
41. A radiograph of an AP axial projection for anterior pelvic bones reveals that
the pubic and ischial bones are not elongated sufficiently. The following
factors were used for this study: 86kV, 7mAs, bucky, 20-30 cephalad angle,
and 40” SID. The female patient was placed in a supine position on the table.
What must be changed to improve the quality of the image during the repeat
exposure?
a. Increase kV to 95kV
b. Increase mAs to 12mAs
c. Increase angle to 30-45 degrees cephalad
d. Increase angle to 30-45 degree caudad
42. A patient enters the ER with a pelvis injury due to a motor vehicle accident.
The initial AP pelvis projection demonstrates a possible defect or fracture of
the left acetabulum. No other fractures are detected and the patient is able to
move comfortably. What additional projections can be taken to demonstrate a
possible acetabular fracture?
a. Posterior oblique hip
b. Posterior oblique acetabulum
c. Unilateral frog leg hip projection
d. AP hip projection
43. Which AEC chambers should be selected for an AP pelvis?
a. Left chamber
b. Right chamber
c. Left and right chamber
d. Middle and left chamber
44. A radiograph from a modified axiolateral projection reveals excessive grid
lines on the image, which also appears underexposed. What can be done to
avoid this problem during the repeat exposure?
a. Grid is upside down, so put it in the proper way
b. CR is not in the middle of the grid, so bring it back into the center &
make sure the CR is perpendicular to the grid
c. Make sure the CR is perpendicular to the grid
d. a) & c)
45. A portable AP and lateral hip study is ordered for a patient who is in recovery
following hip replacement surgery. The radiograph of the AP hip reveals that
the upper portion of the acetabular prosthesis is slightly cut off but is included
on the lateral projection. Should the technologist repeat the AP projection?
Why or why not?
 a. No, because the ROI was in profile on the lateral projection
b. No, the femoral neck is the ROI and got on the radiograph
c. Yes, because you don’t know how the prosthesis is situated
d. Yes, because you should at least get the iliac crest on the radiograph
46. A patient with hip pain from a fall enters the emergency room. The physician
orders a left hip study. When moved to the radiographic table, the patient
complained loudly about the pain in the left hip. Which positioning routine
should be used for this patient?
a. Left axiolateral hip
b. AP pelvis with rotation, then left modified axiolateral hip
c. Left axiolateral hip, then AP pelvis
d. AP pelvis without rotation, then left modified axiolateral hip
47. A patient has just been moved to his hospital room after a bilateral hip
replacement surgery. The surgeon has ordered a postoperative hip routine for
both hips. Which specific positioning routine should be used? (the patient can
be brought to the radiology department)
a. AP pelvis
b. AP pelvis, then modified axiolateral hip
c. Modified axiolateral hip
d. AP pelvis, then axiolateral hip
48. A patient with a possible pelvic ring fracture from a trauma enters the
emergency room. The AP pelvis projection, which was taken to determine
whether the right acetabulum is fractured, is inconclusive. Which other
radiographic projection can be taken to better visualize the acetabulum?
a. Inlet axial projection
b. Outlet axial projection
c. Posterior oblique pelvis -acetabulum
d. Unilateral frog hip projection
49. A young patient comes to the radiology department with a chronic pain near
the ASIS. She is an active athlete who injured her pelvis while running
hurdles. Her physician suspects an avulsion fracture. Which position may best
diagnose this condition? Must the technologist increase or decrease kV for
this projection to demonstrate the fracture?
a. Decrease kV to 65-70kV from 85-90kV, include AP pelvis & Judet
method hip projection
b. Decrease mAs from 8mAs to 4mAs, include AP pelvis & Judet method
hip projection
c. Decrease kV to 65-70kV from 85-90kV, include AP pelvis
d. Decrease mAs from 8mAs to 4mAs, include Judet method hip
projection
50. A young child comes to the radiology department with a clinical history of
DDH (developmental dysplasia of hip). What is the most common positioning
routine for this condition?
a. Inlet axial pelvis projection
 b. Outlet axial pelvis projection
c. AP pelvis projection only
d. AP pelvis projection or bilateral frog leg projection
51. A geriatric patient with an externally rotated lower limb may have:
a. A normal hip joint
b. Osteoarthritis
c. Fracture proximal femur
d. Slipped capital femoral epiphysis
52. Which one of the following pathologic indications may result in the early fusion
of the SI joints?
a. Chondrosarcoma
b. Metastatic carcinoma
c. Developmental dysplasia of the hip
d. Ankylosing spondylitis
53. Match each of the following radiographic appearance with the correct
pathologic indications
1. Usually consists of a. Pelvic ring fracture
numerous small lytic b. DDH
lesions c. Osteoarthritis
2. Increase hip joint space d. Slipped capital femoral
and misalignment epiphysis
3. Bilateral radiolucent lines e. Ankylosing spondylitis
across bones and f. Metastatic carcinoma
misalignment of SI joints
4. Early fusion of SI joints
and “bamboo spine”
5. Epiphysis appear shorter
and epiphyseal plate wider
6. Hallmark sign of spurring
and narrowing of joint
space

54. A patient enters the emergency room with a possible pelvic ring fracture. The
AP pelvis projection is inclusive on the extent and location of the fractures.
What additional pelvis projection can be taken on this patient to demonstrate
possible fractures? (There are multiple answers to this question. Choose the
most correct answer).
a. Posterior oblique acetabulum (Judet method) for pelvic ring &
acetabulum
b. Posterior oblique acetabulum (Judet method) for DDP
c. Inlet/Outlet AP axial projection for acetabular fractures
d. Inlet/Outlet AP axial projection specifically for femoral neck fractures
55. A radiograph of an AP projection of the pelvis demonstrates that the left
obturator foramen is narrowed and the right one is open. What is the specific
positioning error present on this radiograph?
 a. Patient is in LPO position
b. Patient is in RPO position
c. Patient is in LPO position, so turn patient more toward the left
d. Patient is in RPO position so turn patient toward the right
56. A radiograph produced using the Taylor method demonstrates that the
anterior pelvic bones of a female patient are foreshortened. The following
positioning factors were used: supine position, 40” SID, and CR angle 30
caudad and centered 1-2” distal to symphysis pubis. Which one of the
following modification should be made during the repeat exposure?
a. Increase CR angle
b. Decrease CR angle
c. Reverse CR angle
d. Center CR at level of ASIS
57. A young patient with a clinical history of slipped capital femoral emphysis
comes to the radiology department. Which projections are most often taken
for this condition?
a. AP pelvis
b. Bilateral AP frogleg projection
c. Both a) and b)
d. None of the above
58. A radiograph of an AP hip reveals that the lesser trochanters are not visible.
Should the technologist repeat the projection?
a. Yes, they should be minimal profile of the projection
b. Yes, the greater trochanters are not visible
c. No, but the lesser trochanters should be visible
d. No, because they shouldn’t visible or with minimal profile on the
radiograph
59. A unilateral frog-leg demonstrates foreshortening of the femoral necks. The
physician is unsure if there is a defect within the anatomical neck. What can
be done to minimize distortion of the neck during a repeat exposure?
a. Decrease abduction of the femurs to 20-30 degrees
b. Decrease abduction of the femurs to 15-20 degree
c. Increase abduction of the femurs to 45 degree
d. Use CR cephalad angle of 20-25 degrees
60. A radiograph of an axiolateral projection of a hip demonstrates a soft tissue
density that is visible across the affected hip and acetabulum. This artifact is
obscuring the image of the proximal femur. What is the most likely cause of
the artifact, and how can it be prevented from showing up on the repeat
exposure?
a. Increase flexion of affected leg and raise it out of the ROI
b. Increase flexion of unaffected leg and raise it out of the ROI
c. This is due to a large angle between the tube and femur, so decrease
the CR angle
 d. This is due to a small angle between the tube and femur, so increase
the CR angle
61. An initial AP pelvis radiograph reveals possible fractures involving the lower
anterior pelvis. The emergency room physician asks for another projection to
better demonstrate this area of the pelvis. The patient is traumatized and must
remain in a supine position. Which projection should be taken?
a. AP axial outlet - elongates the pubis and ischium
b. AP axial outlet - foreshorten the pubis and ischium
c. AP axial inlet - elongates the lower anterior pelvis
d. AP axial inlet - foreshortens the lower anterior pelvis
62. What type of CR angle is required for the Judet method?
a. 12 cephalad
b. 5-10 caudad
c. 15 cephalad
d. None of the above
63. T/F: The modified axiolateral is classified as a nontraumatic lateral hip
projection
a. True
b. False
64. T/F: centering for the AP pelvis is 1” superior to the symphysis pubis
a. True
b. False
65. T/F: centering for the AP frog-leg projection is 1” superior to the symphysis
pubis
a. True
b. False
66. Which one of the following projections or methods is often performed to
evaluate a pediatric patient for congenital hip dislocation?
a. Bilateral frog legs
b. Unilateral frog
c. AP pelvis
d. Judet method
67. Which one of the following radiographic signs indicates that the proximal
femurs are in position for a true AP projection?
a. Appearance of the greater trochanter in profile
b. Limited view of fovea capitis
c. Limited view of the lesser trochanter in profile
d. Symmetric appearance of iliac wings
68. Which one of the following pathologic indications may result in the early fusion
of the SI joints?
a. Chondrosarcoma
b. Metastatic carcinoma
c. Developmental dysplasia of the hip
d. Ankylosing spondylitis
69. A geriatric patient with an externally rotated lower limb may have:
a. A normal hip joint
b. Osteoarthritis
c. Fractured proximal femur
d. SCFE
70. Which of the following devices should be used for an axiolateral projection of
the hip to equalize density of the hip region?
a. Grid
b. High-speed IR
c. Small focal spot
d. Compensating filter
71. If a compensating filter was used for the axiolateral hip projection, how would
it be situation on the radiograph?
a. Thin portion over acetabulum
b. Thin portion over mid femur
c. Bow-tie filter over femur
d. Trough filter over femur