Radiography and CT are used to evaluate pelvic and acetabular fractures. The Judet-Letournel classification system is used to classify fractures for better treatment planning and prognostication. Common fracture types include T-shaped, both-column, transverse, and elementary posterior wall fractures. Radiographs can identify disrupted ilioischial and iliopectineal lines but CT better characterizes occult fractures and fracture fragments. Examples shown include a T-type fracture disrupting both lines, a transverse fracture disrupting both lines with intact pubic rami, and a posterior wall fracture disrupting the posterior rim.

1. RADIOGRAPHY WITH CT CORRELATION IN PELVIC
ACETABULAR TRAUMA
Mahesh Prakash, Stanzin Spalkit, Anindita Sinha, Manavjit Sandhu
PGIMER, Chandigarh, India
Presenting Author-Dr Mahesh Prakash

2. Objective-
To review relevant anatomy and to recognise the plain radiographic findings with subsequent
CT correlation and classification of acetabular fractures.
Why should we classify the acetabular fractures?
Better evaluation and planning of subsequent management.
Prognostication
Helps grouping various fracture types and standardizing treatment protocols.
Imaging
Pelvi-acetabular fractures is evaluated on the anteroposterior projection of radiographs of the
pelvis and hip, this is further supported by special projections. CT has a major role in better
characterization of radiographically occult posterior ring fractures and the acetabular
fractures. Planar and 3D CT images are used to better depiction of these fractures
• Here in this short exhibit we are showing the Radiographic and CT findings of few common
acetabular fractures.

3. Relevant anatomy
Landmarks on AP, and Judet views view
1. Iliopectineal line
2. Ilioischial line
3. Teardrop
4. Dome/Roof
5. Anterior wall
6. Posterior wall
AP
OBTURATOR VIEW ILIAC VIEW
4
3 1
2
5
6

4. Judet-Letournel classification system of acetabular fractures
Elementary Fractures
1. Posterior wall
2. Posterior column
3. Anterior wall
4. Anterior column
5. Transverse
Common types include:
1. T-type
2. Associated both-column
3. Transverse
4. Transverse with posterior wall
5. Elementary posterior wall fractures
Associated Fractures
1. T-shaped
2. Posterior wall plus posterior column
3. Posterior wall with transverse
4. Anterior column or wall with posterior hemi transverse
5. Both columns

5. T TYPE
Radiographs:
a)AP view:Iliopectineal and Ilioischial line disrupted(arrow)
Judet views:b)iliac oblique view: disruption of iliopectineal line(arrow)
Superior and inferior pubic rami fracture(black arrow)
c)Obturator oblique view: disruption of ilioischial line(arrow)
Superior and inferior pubic rami fracture(black arrow)
CT:
Fracture line in sagittal plane(arrow)
Superior and inferior pubic rami fracture(yellow arrow)

6. TRANSVERSE
Radiograph:
Both Iliopectineal and Ilioischial line
disrupted(arrow)
CT:
Fracture line in sagittal plane(arrow)-on planar
images
Superior and inferior pubic rami intact(yellow
arrow
in VRT images)

7. TRANSVERSE WITH POSTERIOR WALL
XRAY:
Both Iliopectineal and Ilioischial line disrupted
(arrow)
Posterior rim disrupted (black arrow)
Posterior dislocation of femoral head
CT:
In planar and VRT images:
Fracture in sagittal plane(arrow) and in oblique
plane along posterior wall(yellow arrow)

8. POSTERIOR WALL
Radiograph:
Disruption of posterior rim of
acetabulum(arrow) with
posterosuperiorly displaced
fracture fragment(black arrow)
Intact iliopectineal and ilioischial
line s/o intact anterior and
posterior columns
CT:
Fracture line in oblique plane(arrow in planar
images)
VRT: showing intact pubic rami and posteriorly
displaced posterior wall fracture fragment(arrow)