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DETERMINING 'PI' VS. 'AS'
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- -Place dots:
- 1. Top of femur heads.
- 2. Superior aspect of iliac crests.
- 3. Inferior aspect of ischial tuberosities.
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- -Draw Lines:
- 1. Femur Head Line.
- 2. Superior Crest Line (#4 on picture).
- 3. Inferior Ischial Line (#5 on picture).
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- Measure from the Superior Crest Line to the Inferior Ischial Line on both sides.
- Record findings in the iliac crests in mm.
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Misalignment determination:
- On the side of LL body rotation.
- Record in iliac fossa.
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PI Listing:
- Increased measurement.
- Increased obturator size.
- Increased lumbar curve (hyperlordosis).
- Shorter LL.
- Larger measurement on side of body rotation.
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AS Listing:
- Decreased measurement.
- Decreased obturator size.
- Decreased lumbar curve (hypolordosis).
- Longer LL.
- Shorter measurement on side of body rotation.
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DETERMINING 'IN' VS. 'EX'
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- -Place dots:
- 1. Center of 1st sacral tubercle (#6 on picture).
- 2. Center of pubic symphysis (#7 on picture).
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- -Draw Lines:
- 1. Sacral Center Line: with your rolling ruler perpendicular to the FHL, draw a line through the 1st sacral tubercle towards your dot in the pubic symphysis.
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- -Measure:
- With your rolling ruler perpendicular to the SCL, measure from the SCL to the center of the pubic symphysis.
- Record findings in the pubic symphysis in mm.
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Misalignment Determination:
- Pubic symphysis deviates to side of IN.
- On side of LL body rotation.
- Written in iliac fossa in mm.
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EX Listing:
- Mimics PI.
- Decreased ilium width.
- Increased obturator size.
- Increased lumbar curve (hyperlordosis).
- Shorter LL.
- Pubis crosses SCL. (IN is IN).
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IN Listing:
- Mimics AS.
- Increased ilium width.
- Decreased obturator size.
- Decreased lumbar curve (hypolordosis).
- Longer LL.
- Pubis does not cross the SCL.
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MD, AD, & HEEL LIFTS. O MY!
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MEASURED DEFICIENCY (MD) LINE:
- 1. Align ruler with top of film.
- 2. Roll ruler to higher femur head.
- 3. MD Line: draw line above LOWER femur head.
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MD MEASUREMENT:
- Measure distance perpendicular from FHL to MD line.
- Record findings above lower femur head, in mm.
- MD: misalignment before adjustment.
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RULES FOR CORRECTION:
- For every 5 mm of AS or IN: the femur head height is lowered by 2 mm.
- For every 5 mm of PI or EX: the femur head height is raised 2mm.
- -For every 1mm multiply by 0.4.
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ACTUAL DIFFERENCE (AD):
- Combines measured difference with correction.
- Signifies anatomical short leg.
- Signifies need for heel lift.
- Written above lower femur head in mm.
- AD = MD +/- correction.
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