title: Radiographic Identification of Arthroscopically Relevant Proximal Femoral Structures.
abstract: BACKGROUND
  Anatomic landmarks located on the proximal femur have only recently been defined, and there is a lack of radiographic guidelines for their locations presented in the literature. With the confident identification of these landmarks, radiographs could provide more assistance in preoperative evaluations, intraoperative guidance, and postoperative assessments.
  
  
  OBJECTIVE
  To quantify the radiographic locations of endoscopic landmarks of the proximal femur.
  
  
  METHODS
  Descriptive laboratory study.
  
  
  METHODS
  Ten cadaveric specimens were dissected, and radio-opaque hardware was placed for each landmark of interest. Radiographs were obtained and measurements recorded in anteroposterior (AP) and Dunn 45° views.
  
  
  RESULTS
  In the AP view, the gluteus medius insertion was located a mean 12.9 ± 2.4 mm and 34.7 ± 5.1 mm from the piriformis fossa and vastus tubercle, respectively. The piriformis fossa was a mean 14.8 ± 5.9 mm and 4.9 ± 1.9 mm from the anterior and posterior tips of the greater trochanter, respectively. The anterior and posterior tips of the greater trochanter were a mean 14.8 ± 5.1 mm from each other. In the Dunn 45° view, the piriformis fossa was a mean 13.3 ± 2.0 mm, and the vastus tubercle was a mean 21.5 ± 6.0 mm, from the gluteus medius insertion. Moreover, the vastus tubercle was a mean 33.5 ± 6.4 mm from the anterior tip of the greater trochanter and 31.6 ± 8.5 mm from the posterior tip of the greater trochanter.
  
  
  CONCLUSIONS
  In spite of the variation in cadaveric sizes, quantitative descriptions of endoscopic landmarks were reproducible in clinical views.
  
  
  CONCLUSIONS
  A detailed understanding of how the described landmarks present radiographically is relevant to preoperative planning, intraoperative evaluations, and postoperative assessments.
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: W Andrew
authors.initials: WA
authors.lastname: Lee
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Adriana J
authors.initials: AJ
authors.lastname: Saroki
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA Department of Orthopaedics, Oslo University Hospital, Oslo, Norway.
authors.forename: Sverre
authors.initials: S
authors.lastname: Løken
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Christiano A C
authors.initials: CA
authors.lastname: Trindade
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Tyler R
authors.initials: TR
authors.lastname: Cram
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Broc R
authors.initials: BR
authors.lastname: Schindler
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA The Steadman Clinic, Vail, Colorado, USA.
authors.forename: Robert F
authors.initials: RF
authors.lastname: LaPrade
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA The Steadman Clinic, Vail, Colorado, USA drphilippon@sprivail.org.
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Philippon
mesh_terms: D000368:Aged; D059925:Anatomic Landmarks / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D001182:Arthroscopy; D002102:Cadaver; D004838:Epiphyses / Q000033:anatomy & histology; D005260:Female; D005270:Femur Head / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D005272:Femur Neck / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D006615:Hip; D006621:Hip Joint / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000033:anatomy & histology; D010865:Pilot Projects; D011859:Radiography; D013848:Thigh
keywords: femoroacetabular impingement (FAI); fluoroscopic guidance; gluteus medius; greater trochanter; hip; hip arthroscopic surgery; piriformis; radiograph; vastus tubercle