Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

13. Imaging for Evaluation of Groin Pain
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Fig. 13.1. Anteroposterior (AP) view of the pelvis is acquired with internal rotation
of the legs, laying out the femoral necks to evaluate for possible fracture.
There is severe osteoarthritic change about the right hip with preferential loss of
the superior, weight-bearing portion of the joint space ( black arrow ) and osteophytosis
( curved black arrow ) and relative preservation of the medial space. In
contrast, the left hip is normal in appearance ( white arrow ). Chronic superior and
inferior pubic rami fractures are seen on the right ( thick black arrows ) with interruption
of the smooth cortical line and callus formation. Significant degenerative
changes of the lumbar spine are partially visualized ( asterisk ).
centers, though it is frequently referenced in the radiologic literature. In
addition to the drawbacks of its invasiveness, it has been obviated by
dramatic technical advances in dynamic CT and MR acquisition.
CT relies on the same principles as plain film radiography . Instead of
acquiring a single image with a set amount of radiation, a CT scanner
acquires many images from many angles, each of which requires much
less radiation than a single conventional radiograph because they are not
meant to stand alone. A sophisticated processing algorithm then integrates
these individual “projections” into a three- dimensional attenuation
map that can be viewed in the axial coronal or sagittal plane, or
some oblique combination thereof. The advance of technology is such
that current generation CT scanners can produce diagnostic images in
any conceivable plane without appreciable loss of resolution. Pathologies