Optimum Positioning for Anteroposterior Pelvis Radiography: A Literature Review

Aim: Pelvic radiography is used for the identification of hip joint changes, including pathologies such as osteoarthritis. Several studies have recommended that the position for this radiological procedure should be standing, not supine, to reflect the functional appearances of the hip joint. The aim of this review was to evaluate pelvis radiography positioning with respect to the image appearances and information provided for clinical decision-making. Aside from this, potential recommendations to the radiographic technique for an erect pelvis projection will be considered. Method: A literature search was performed using databases/abstract systems (ScienceDirect, Web of Science, PubMed, and MEDLINE). Only articles written in English were included. Results: Twenty-five articles were identified. Findings from the review describe the effect of repositioning from supine to erect on a series of specific hip measurements. These include pelvic tilt, joint space width, and the acetabular component. Conclusion: Evidence within the literature illustrates that in several studies, there were differences when repositioning from supine to standing for a number of pelvic metrics. Standing positioning is promoted by some authors since this may facilitate the early diagnosis of hip joint pathology and assist in the planning of surgical interventions. Literature is very limited on how to optimally perform erect pelvis radiography, and this should be an area for future research.