Normal Hip X-Ray Report Template
Normal hip radiograph report template: AP pelvis and lateral views, Shenton line, joint space and trabecular pattern, with occult fracture wording notes.
EXAMINATION: Hip radiograph, [right/left], AP pelvis and lateral views. CLINICAL HISTORY: [indication] COMPARISON: None available. TECHNIQUE: AP view of the pelvis and lateral view of the [right/left] hip. FINDINGS: Alignment: Anatomic. Shenton line is intact. No dislocation. Bones: No acute fracture. The femoral head, neck and intertrochanteric regions show normal cortical contours and trabecular pattern. The acetabulum and visualized pubic rami are intact. Joints: The hip joint space is preserved. No significant degenerative change. The visualized sacroiliac joints and pubic symphysis are unremarkable. Soft tissues: Unremarkable. No radiopaque foreign body. IMPRESSION: 1. No acute fracture or dislocation.
Dictation notes
- A negative radiograph with persistent inability to bear weight is an occult femoral neck fracture until MRI says otherwise — put the recommendation in the impression.
- Trace both pubic rami on the AP pelvis; a ramus fracture is the classic second injury accompanying a fall.
- Disrupted Shenton line with intact cortex suggests an impacted or subtle displaced neck fracture — look again before signing.
Frequently asked questions
What belongs in a normal hip X-ray report?
A normal hip radiograph report — typically an AP pelvis plus a lateral of the affected hip — confirms anatomic alignment with an intact Shenton line, no fracture of the femoral head, neck, intertrochanteric region, acetabulum or visualized pubic rami, preserved joint space, and unremarkable sacroiliac joints and pubic symphysis. The normal impression reads 'No acute fracture or dislocation.'
What should be done when hip X-rays are normal but the patient cannot bear weight?
A negative radiograph with persistent inability to bear weight should be treated as an occult femoral neck fracture until advanced imaging says otherwise, and the report's impression should recommend MRI — the most sensitive study for radiographically occult fracture. Undisplaced femoral neck fractures can be invisible on radiographs, and a missed fracture that displaces converts a screw fixation into an arthroplasty.
What is the Shenton line and why does it matter?
The Shenton line is the smooth curve formed by the inferior border of the superior pubic ramus and the medial femoral neck on an AP radiograph. Disruption of the line with apparently intact cortex suggests an impacted or subtly displaced femoral neck fracture and warrants a second look before signing. Both pubic rami should also be traced on the AP pelvis — a ramus fracture is the classic second injury after a fall.
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