1. Dr/ ABD ALLAH NAZEER. MD.
Radiological Imaging of Anteversion angle.

2. Femoral neck anteversion is defined as the angle between
an imaginary transverse line that runs medially to laterally
through the knee joint and an imaginary transverse line passing
through the center of the femoral head and neck . In adults
without pathology, the femur is twisted so the head and neck of
the femur are angled forward between 15 and 20 degrees from
the frontal plane of the body. In some instances, the FNA angle is
directed forward or backward well beyond this angle. Some
researchers suggest that FNA angles outside this 15- to 20-degree
average are a contributing factor in many different orthopedic
problems in the lower extremity that are commonly seen by
physical therapists. The purpose of this Update is to describe how
FNA is related to hip rotation, how hip rotation range of motion
can be used to predict abnormal FNA, and how asymmetries in
hip rotation may be used to identify patients who may be at risk
for developing various orthopedic problems in the hip and lower
extremity.

4. What causes femoral anteversion?
Femoral anteversion can be the result of stiff hip muscles due to the
position of the baby in the uterus. It also has a tendency to run in
families. Typically, a child's walking style looks like that of his or her
parents.
When the child is first learning how to walk, femoral anteversion
can create an intoeing appearance. As the knees and feet turn in,
the legs look like they are bowed. The bowed leg stance actually
helps the child achieve greater balance as they stand. Balance is not
as steady when they try to stand and walk with their feet close
together or with their feet turned out. This may cause them to trip
and fall.
How is femoral anteversion diagnosed?
The diagnosis of femoral anteversion is made by a history and
physical examination by your child's doctor. During the
examination, the doctor obtains a complete prenatal and birth
history of the child and asks if other family members are known to
have femoral anteversion. Generally, no X-rays are necessary.

5. CT protocols: Femoral anteversion:
This limited study allow the radiologist to
measure the angle of rotation of femoral neck
relative to the femoral condyles bilaterally.
A secondary measurement is femoral lengths,
made by calculating the difference in table
position at the ends of the bones.
Radiographic Scanogram:
This is a radiographic study in which coned-down
images of both hips, knees &ankles are shot on a
single conventional-sized film(or CR plate) with a
radiopaque ruler in place.
The sole purpose of this study is to measure leg-
length. This is a radiographic study in which both
leg are images in their entities from hip to ankle
on a single long film using a scoliosis cassette.
Typically, these are used by orthopedic surgeons
for planning purposes.

8. CT protocol for femoral anteversion measurement.
Measure right and left side individually, Find the slice that reveals the alignment of
the femoral neck, Measure the neck-Horizontal angle, Find the slice that best reveals
the alignment of the femoral condyles, measure the condyle- Horizontal angle and
calculate the angle of the neck relative to the condyles.

10. Thank You.