Pelvis (Judet view)

Radiopaedia • CC-by-nc-sa 3.0 • de

The oblique pelvis otherwise known as the Judet view is an additional projection to the pelvic series when there is suspicion of an acetabular fracture.

Indications

The Judet view is comprised of two projections, first the iliac oblique for assessment of the posterior column and anterior wall of the acetabulum; secondly, the obturator oblique view demonstrating the anterior column of the pelvis along with the posterior wall of the acetabulum.

Patient position

  • iliac oblique
    • patient is supine
    • the unaffected side is rotated roughly 45° anterior, generally aided by a 45° sponge
    • it is advisable that the patient is positioned central on the table and at no risk of over-rolling
  • obturator oblique
    • patient is supine
    • the affected side is rotated roughly 45° anterior, generally aided by a 45° sponge
    • ensure the patient is central on the table and at no risk of over rolling

Technical factors

  • anteroposterior projection
  • centering point
    • iliac oblique
      • 5 cm distal and 5 cm medial of the ASIS closest to the image receptor
    • obturator oblique
      • 5 cm distal and 5 cm medial of the ASIS that is rolled up anterior to the image receptor
  • collimation
    • superior to the level of the ASIS
    • inferior to the proximal femur
    • laterally to the skin margins
    • medially to the pubic symphysis
  • orientation  
    • portrait
  • detector size
    • 24 cm x 30 cm
  • exposure
    • 70-80 kVp
    • 10-20 mAs
  • SID
    • 100 cm
  • grid
    • yes

Image technical evaluation

The iliac oblique projection should demonstrate the anterior rim of the acetabulum as well as the posterior ilioischial column. The iliac wing, as it is 'flatten' out on the image, should be well demonstrated.

The obturator oblique projection should distinctly show the posterior rim as well as the anterior ilioischial line. As per the name, the obturator foramen is well demonstrated.

Practical points

The 'Judet view' is a two-part view of the acetabulum, the collimation of the Judet views is departmentally dependent.

Some institutions will advise the Judet views are done as a full two view oblique pelvis (see figure 1 and 2). In this case, it would be a landscape projection with a full-sized detector, with the same centering parameters as the AP pelvis.