What does a pelvic x-ray show in women and men and when is it prescribed?

The pelvis is a part of the skeleton that is located at the base of the spinal column. It not only provides support for the internal organs, but also provides fixation to the legs to the body. That is why his health plays an important role, and x-rays of the pelvic bones are an integral component of diagnosis for diseases and injuries in this area.

It is a highly informative diagnostic method that allows you to obtain data on the condition of the bone structures and joints of the pelvis, determine damage and pathologies of soft tissues and internal organs. Radiography is widely used in clinics, so it is an affordable method, including in terms of price. You can take an x-ray of the bones of the small and large pelvis at the diagnostic center of the multidisciplinary clinic CELT. We have modern equipment, and our specialists practice an individual approach, which invariably allows us to achieve high quality radiographic images.

X-ray of the pelvic bones - RUB 2,200.

15 - 20 minutes

(duration of procedure)

Indications

Diagnosis is carried out exclusively as prescribed by a doctor in the presence of clinical manifestations that indicate the following pathological changes in the pelvic bones:

Cracks, hematomas, bruises, fractures, dislocations;
Reduced density of bone structures (osteoporosis);
Developmental anomalies;
Subluxations and dislocations of the hips;
Lesions of the joints of an infectious nature, as well as due to disruption of the body’s metabolic processes;
Neoplasms of benign or malignant nature;
Metastatic foci with neoplasms located in other places;
Assessing the effectiveness of treatment tactics and the need for its correction.

Contraindications

Modern medicine identifies a number of conditions in which radiographic examinations are not recommended. These include:

Pregnancy and breastfeeding in women;
A large dose of radiation received over the past year;
The patient's age is up to 15 years;
The patient's serious condition.

Despite the safety of modern techniques, it is generally accepted that even a minimal dose of radiation can have a negative effect on patients in the above groups. At the same time, if absolutely necessary (if it is vital), radiography is still performed.

X-ray examination of the pelvic bones

To most accurately determine pathologies of the pelvic bones, radiography is most often used. This is a simple technique, the result of which is highly informative and accurate. The main advantages of x-rays are:

accessibility – there is an X-ray machine in almost every clinic;
painlessness;
relative safety;
efficiency - together with decoding, this diagnostic procedure lasts approximately 10 minutes;
simple preparation for a pelvic x-ray (how to do it will be described below).

Preparation requirements for hysterosalpingography

The diagnostic procedure is mainly prescribed for the first half of the menstrual cycle. It is best to carry it out in the first few days after the end of menstruation, but hysterosalpingography is allowed within two weeks after its completion. Such requirements are determined by the structural features of the female body - during this period the endometrium of the uterus is thinnest and the cervix is soft, so inserting a catheter requires practically no effort, and the doctor has a better view. In this case, it is imperative to wait until the release of menstrual blood stops completely, since the presence of blood clots in the vagina and uterus makes diagnosis very difficult.

As for determining the patency of the fallopian tubes, the procedure for this purpose is recommended to be carried out during the second phase of the cycle.

Also, as a preparation, the doctor usually directs the woman to undergo general blood and urine tests and a smear for flora. Before conducting the examination, it is necessary to make sure that there are no pathogenic microflora in the vagina, since catheterization of the uterus in this case can lead to infection entering its cavity.

Indications for radiography

Indications for pelvic radiography

are:

traumatic injuries of the hip joint;
suspicion of a tumor of the hip bones;
inflammatory diseases of the hip joint;
suspected pathology of the pelvic ring;
dislocations of the hip joint.

What does a pelvic x-ray show?

Let's take a closer look at what a pelvic x-ray can show. X-ray of the pelvis and hip joint

may show the following pathologies:

osteoporosis;
dislocation and subluxation of the hip;
fractures of the pelvis, hip joint of various locations and complexity;
arthritis or arthrosis;
Perthes disease (osteochondropathy of the femoral head);
tumor-like neoplasms.

Recommendations by category of patients

Unlike Rg methods for examining joints, X-rays of the pelvic bones are rarely used. It is prescribed when diagnosis cannot be made by other means. Main indications for x-rays:

traumatic (bruises, blows, falls, accidents);
difficulty walking, which may indicate neoplasms (oncological and benign);
inflammation in the pelvic area (the risk of bone damage is higher than the threat of radiation);
threat of articulation rupture due to a pathological defect.

Pelvic X-ray is recommended for women planning a pregnancy (six months before conception) who are at risk for damage/diseases of the pelvic ring. The pelvic bones are also examined during restorative/rehabilitation therapy after fractures, dislocations and bruises.

Features of the event

X-ray of the pelvis in men

For men, a pelvic x-ray, as practice shows, can be prescribed as the main procedure for diagnosing prostatitis. In this case, the pathology can be of any type - acute, chronic, bacterial or non-bacterial. The main symptoms of this disease are: pain in the scrotum and perineum, problems with urination, deterioration in sex life, changes in seminal fluid and difficulty in ejaculation.

X-ray of the pelvis in women

For women, a pelvic x-ray can be prescribed as an additional diagnosis of infertility and to identify the causes of disturbances in the functioning of the organs of the reproductive system.

How is the examination carried out?

Typically, x-rays are taken in a direct (antero-posterior) projection. The examination is carried out in a strictly horizontal position of the subject. The patient lies down on the work table of the X-ray machine, extends his legs and rotates them inward by approximately 15° (provided that he does not suspect a fracture or dislocation of the hip joint). A special cushion is placed under the knees of the person being examined. The elbows are located on the sides of the body, the hands are placed on the chest.

During filming, the patient must remain motionless and after taking a deep breath, do not breathe for several seconds. The quality of the pictures depends on this.

In addition to X-rays of the pelvis in a direct projection, other images can be taken to clarify the diagnosis:

in the posterior axial projection of the pelvic inlet;
in the posterior oblique projection of the pelvis.

Computed tomography technique

Before starting the diagnosis, the patient talks with a radiologist. The specialist is interested in such aspects as a preliminary diagnosis, whether there have been surgical operations in the past, the results of previous examinations, whether there are any metal structures in the body, etc. Then the patient takes off things that could distort the image and lies down on the mobile table of the device. The doctor adjusts the settings, places the patient in the ring-shaped chamber of the CT scanner, and monitors the scan on a computer monitor in an adjacent room. The procedure lasts from 5 to 15 minutes. During this time, the subject must lie still.

Native diagnosis is usually not accompanied by discomfort. Mild malaise, dizziness, and nausea sometimes appear after the administration of contrast, but these phenomena pass rather quickly. Computed tomography, as a rule, does not cause complications, and after the procedure you can return to your usual activities.

Fibrous dysplasia of the pelvic bones on CT

Fibrous dysplasia is a tumor-like disease characterized by impaired skeletal development with partial replacement of bone structures by connective fibers. Because the new tissue is not strong enough, fractures occur repeatedly in the affected area. Most often, one or both iliac bones are involved in the pathological process, very rarely – the ischium and pubis.

The disease is caused by disorders of intrauterine development and mainly occurs in children and adolescents. The peculiarity of fibrous dysplasia of the pelvic bones is the absence of symptoms at the initial stage. In the early stages, it is accidentally discovered during an examination for another reason.

The diagnosis is made on the basis of the clinical picture and the results of an X-ray or MSCT of the hip joint: the images show an increase in the volume of the pelvic bones without disturbing their contours and foci of darkening resembling ground glass.

Decoding the results

Immediately after the x-ray, the radiologist begins interpreting and describing the images. To do this, he needs to assess the following qualitative and quantitative indicators:

size of the neck-shaft angle;
the magnitude of the Wiberg angle and the degree of change;
the angle of the femoral neck (to identify antetorsion, inclination);
value of the width of the sacroiliac joint;
the width of the gap between the bones of the hip joint.

The following additional pathological signs are also accepted for analysis:

deformation of the femoral head;
dislocations and subluxations of the hip joint
;
rotation of joint bone fragments;
displacement of the femur in width or length;
expansion/constriction of the symphysis.

When interpreting, the radiologist does not make a specific diagnosis. He describes the pathological signs that are visualized in the images, and the attending physician correlates them with other pronounced clinical signs and makes a conclusion about the presence of a particular disease.

Normal indicators

The X-ray image should show a symmetrical image of the two halves of the pelvis, the sacrum, the intervertebral foramina of the sacrum, as well as the branches of the pubic and ischial bones. The bone substance should be clearly visible, the contours of the two acetabulums and the neck of the femur should be visible.

There are certain indicators of the normal condition and structure of the hip joint, with which the actual data are compared when deciphered. For example, the Wiberg angle should normally be located between the line of the center of the femoral head and the superior-outer edge of the acetabulum. The normal angle is approximately 30 degrees. The angle of inclination of the entrance to the acetabulum is also normal - 31-42 degrees. The neck-shaft angle should normally be from 115 to 140 degrees.

Diagnostic results: what to do next

The obtained images of the uterus and fallopian tubes, or images of echohysterosalpingoscopy, are interpreted by a diagnostician. He draws up a conclusion on them, in which he displays the most objective and reliable information.

X-rays show the filling of the fallopian cavity and fallopian tubes with contrast material. If the drug passes freely through the tubes and is visualized in the abdominal cavity, then everything is in order with the patency of the fallopian tubes. If the image clearly shows that the fluid did not pass and stopped at a certain level, this confirms the presence of obstruction. The alternation of dark and light areas in the pipes in the image indicates that they have adhesions.

In addition, the peculiarities of the distribution of contrast throughout all examined cavities and organs makes it possible to see neoplasms, polyps, and foci of inflammation.

Also, the diagnostician draws conclusions about the size of the uterus and fallopian tubes, the features of their structure and location, and the structure of the inner wall of the uterus from photographs or the monitor of an ultrasound machine. For example, its uneven relief may indicate the presence of adhesions, inflammation, polyps or fibroids.

If the results of the examination give reason to suspect the presence of uterine cancer, it is necessary to order additional examinations, including taking tissue for a biopsy.

The diagnostic doctor's conclusion, along with the photographs, is transmitted to the attending physician, who referred the woman for examination.

After hysterosalpingography, the patient may experience mild vaginal bleeding for several days. Pain in the lower abdomen that appears during the examination usually goes away after 20-30 minutes. In the next 3-4 days, you should avoid sexual intercourse, visiting a bathhouse, sauna, or taking a bath.

Contraindications for

X-rays of the pelvis and other organs, bones and joints, as numerous studies show, can have a negative impact on the human body. Although, of course, there are very few practical cases of identifying pathologies caused by x-rays. However, there are several contraindications to pelvic x-rays that must be taken into account when prescribing this procedure:

pregnancy (all trimesters);
children under 15 years of age;
serious condition of the patient.

If an x-ray is not advisable, doctors may choose another diagnostic technique that can also be used to assess the condition of the hip joint. For example, MRI or CT.