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Normal Pelvis X-Ray Report Template (AP)

Normal AP pelvis radiograph report template: pelvic ring, sacroiliac joints, pubic symphysis, acetabula and femoral heads, Shenton's line, proximal femora and soft tissues, with notes on the ring principle, occult hip fracture and the inlet-outlet and Judet views.

EXAMINATION: Pelvis radiograph, AP view.

CLINICAL HISTORY: [indication, e.g. “Fall from standing, right hip
pain, unable to bear weight” / “Motor vehicle collision, pelvic
tenderness” / “Chronic bilateral hip pain”]

COMPARISON: None available.

TECHNIQUE: AP view of the pelvis [supine]. [Additional frog-leg
lateral view of the right hip.]

FINDINGS:
Pelvic ring: Intact. The pubic symphysis is normally aligned with a
width of [x] mm (normal under 5 mm). The sacroiliac joints are
symmetric and normal in width without diastasis. The iliopectineal
and ilioischial lines are intact bilaterally. The sacral arcuate
lines are intact and symmetric. No fracture of the iliac wings,
superior or inferior pubic rami or ischia.
Acetabula and hips: The acetabular roofs, anterior and posterior
walls and teardrops are intact and symmetric. The femoral heads are
normally seated within the acetabula bilaterally. Shenton's line is
intact bilaterally. No hip dislocation.
Proximal femora: The femoral heads, necks, intertrochanteric regions
and visualized proximal shafts are intact. No cortical disruption,
trabecular angulation or sclerotic band to suggest an occult
femoral neck fracture. The greater and lesser trochanters are
intact.
Joint spaces: The hip joint spaces are preserved and symmetric
without osteophyte, subchondral sclerosis or cyst.
Mineralization: Normal.
Lumbar spine and sacrum (visualized): The lower lumbar vertebrae and
sacrum are unremarkable. No transverse process fracture.
Soft tissues: Unremarkable. No radiopaque foreign body. [Normal
bowel gas pattern on the included abdomen.] [Phleboliths in the
pelvis, incidental.]

IMPRESSION:
1. No acute fracture or dislocation of the pelvis or hips.
2. [No radiographic evidence of hip osteoarthritis.]

Dictation notes

The pelvis is a ring and rarely breaks in one place: a pubic ramus fracture should prompt a second look at the sacral ala (arcuate lines) and the sacroiliac joints, and symphyseal widening over 2.5 cm implies posterior ring disruption.
A negative AP pelvis does not exclude a hip fracture in an elderly patient who cannot bear weight: up to 10% of femoral neck fractures are radiographically occult, and the report should recommend MRI (or CT if MRI is unavailable) when the clinical suspicion persists.
Trace Shenton's line and the iliopectineal and ilioischial lines on every film; a break in one of the acetabular lines is an acetabular fracture that gets Judet views or CT, and posterior hip dislocation shows a smaller-appearing femoral head sitting superolaterally.
In a trauma patient, the AP pelvis is a screening film: inlet and outlet views or, more often now, CT define the ring injury and the report should name the Young-Burgess mechanism (lateral compression, anteroposterior compression, vertical shear) when one is visible.
Describe hip osteoarthritis by its features (joint space narrowing with superolateral migration, osteophytes, subchondral sclerosis and cysts) and grade it; note femoroacetabular impingement morphology (cam, pincer, crossover sign) in younger patients with groin pain.

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This is a reference implementation of a published guideline, for use by qualified clinicians. It does not account for patient-specific factors and is not a substitute for clinical judgment or a formal radiology consultation. Templates are generic scaffolds for licensed radiologists; verify wording against your own practice standards. See our full disclaimer.