Common Misconceptions of Normal Hip Joint Relations on Pelvic Radiographs

This study defines normal bilateral variations in offset and hip center location on pelvic radiographs. The relationship of the femoral head center to the tip of the greater trochanter and that of offset to medullary canal diameter are also defined. Measurements of the offset, hip center location, height of the tip of the greater trochanter from the femoral head center, and medullary canal diameter were carried out on 100 normal pelvic radiographs. The offset of one hip was found to predict that of the contralateral hip to within 4.62 mm with 95% confidence. Their hip center locations differed by 6.3 mm. The tip of the greater trochanter was, on average, 8 mm higher than the femoral head center. Although offset generally increased with an increase in medullary canal diameter, frequent discrepancies occurred in their relationship.