192 Chapter 8 Bones, Part 2: The Appendicular Skeleton

Base of sacrum

Iliac crest

Sacroiliac
joint
Iliac fossa Anterior
superior iliac
spine
Sacral
llium promontory

Coxal bone
(os coxae Anterior
Sacrum inferior iliac
or hip bone)
spine

Pubis Coccyx Pelvic brim

Acetabulum

Pubic tubercle
Ischium Pubic crest
Pubic symphysis
(a) Pelvic girdle Pubic arch

Tubercle of
the iliac crest

Anterior gluteal Ilium

line
Ala
Posterior Iliac fossa
gluteal line Iliac crest Tuberosidad iliaca

Anterior Posterior
superior superior
Posterior iliac spine iliac spine
superior Inferior
iIiac spine gluteal line
Posterior
Anterior inferior inferior
Posterior inferior iliac spine Body of iliac spine
iliac spine Arcuate the ilium
Acetabulum Auricular
Greater sciatic line
surface
notch Superior ramus
of pubis
Ischial body Ischial spine
Pubic spine
Ischial spine Obturator
Pubic body foramen
Lesser sciatic
notch Pubis Ischium
Ischium Articular surface of Ischial ramus
pubis (at pubic
Ischial symphysis) Ilium
tuberosity
Inferior ramus Ischium
Ischial ramus of pubis Cresta pectínea
Pubis
(b) Lateral view, right hip bone (c) Medial view, right hip bone

Cresta del pubis

 Lower Extremity Surface anatomy ~ Skeleton ~ Imaging ~

Hip bone

Spn.lll- postwtor .up.tor

.,..,.,'--__ Spll'llllll- postwtor llrftrtor

fig. 4.10 Hip bone, 0. coxee, right IIide; medial view. posterior and anterior. respectively. The Feci• auricularia serves as
The hip bone consists of three parts, the ilium (Os llum), ismium lOs articular surface for the sacrc:Hiiac joint. The Discus imerpubicus is at-
ilchium), and pubis (0. pubil). The ilium forms the false pelvis, ischi- tached to the Fecies symplrvsilil.
um and pubis form the bony ring around the obturator foramen from

___
{
~~:.-:;: .,.:....,
Crflltlllllla

Lalllum ut.smu1m-----1o

F<aallliiCa--..;:..;:..;:
8plne IIIIa lr!Wior aiP'M'IIII'--~·l

Corpu• 08118 Ill - - -.;,...._,

&rllnallllce ...-..rtor lnfwlor ----::~""'

U1lbU8 acelabiAI

AcltlbuiLim 111cle8
Follllaacelabull
{
lnclslft aoetabull

Rg. 4.11 Hlp bone, Os coxae.. right side: ventral view.

252
Muscles _. Topography _. Sections

Hip bone

u~ atutea ll1tiiiiDr

Fsl.. 1111De Urwa gtutee. lrlllflar

{
u~ atutea pcebiiiDr

Rg. 4.12 Hlp bone. Os coae. right llcle: dorsolateral view. {Os ischium! and the pubis (Os pubis), contribute to the fonmation of
All three parts of the hip bone, namely the ilium (Os ilium). the ischium the acetabular fossa (Acetabulum).

Raml.l8 oesta tscllll

Rg. 4.13 Hlp bone. Os COXM. of • e.,...r-old child. right side; linked by a Y-shaped cartilaginous synchondrosis in the Acetabulum.
latetal view. This cartilaginous synchondrosis ossifies between the age of 13 to 18.
The three parts of the hip bone (Os ilium, Os ischium. Os pubis) are

Clinical R e m a r k s - - - - - - - - - - - - - - - - - - - - - - - - - . .
With high-energy trauma and high impact on the S1retched lowar cartilaginous synchondroses in the area of the Acetabulum needs to
limbs, a ftacture of the acetabular fossa may occur with dislocation be considered for radiogtaphic images in children and adolescents
of the femotal head (centtal fracture-dislocation of the hip). to avoid confusion of the cartilaginous synchondroses with an ac&-
The development of the juvenile hip bone with ossification of the tabular fracture deft.

253
 Lower Extremity
Pelvis
LIMet.mllllllla
O.llum
fig. 4.5 Pelvia, Pelvil; vantral cranial view.
Sacro-iliac joint (Articulatio sacroiliaca) and pubic symphysis {Symphysis
pubical connect the two hip bones (Ossa coxae) and the sacrum lOs
sacrum). The resulting stable ring formation encompasses the viscera
with its iliac bones and transfers the weight of the body to the lower
extremities.
The Lin.. tllrminalil begins at the pubic symphysis with the Pecten
ossis pubis and continues through the Linea arcuata to the promontory
fig. 4.6 and Fig. 4.7 Pelvil,. Pelvia,. of 1 wom~n C... Fig. 4.6) •nd of
• man c~ Fig. 4.7).
The shape of the peMs shows differences between the sexes. In men,
the peMc inlet is rather heart..shaped. The smaller pubic angle is refer-
red to as Angulus subpubicus I~ Fig. 4.411. In women, the peMc inlet
is transverse oval in shape. In addition. the inferior pubic angle (Arcus
pubis, ... Fig. 4.42), the distance between the ischial tuberosities. and
the wings of ilium are larger than in men.
250
Surface anatomy ~ Skeleton ~ Imaging ~
(Pn:lmontorium). The Linea terminalis encirdes the peMc inlet (Apef'o
tur• pelvil superior) and separates the cranill faiH lllrga} pelvil
{PeMs major) from the caudal true 111111111 pelvis (Pelvis minor). The
promontory is the part of the vertebral column that protrudes farthest
into the peMc inlet. The pelvic outlet lAperura plhil im.ior) is con-
fined by the inferior margin of the pubic symphysis anteriorly, the isctli-
al tuberosities laterally, and the tip of the coccyx posteriorly.
The following inner diameters are used to determine the width of the
peMc inlet: the obstetric conjugate diameter (Diameter vera) between
the posterior aspect of the pubic symphysis and the promontory. the
transverse diameter (Diameter transversa) between the most lateral
points of the Linea terminalis on both sides. and the oblique diameter
{Diameter obliqua I and II) which connects the Articulatio sacroiliaca of
each side with the corresponding most distal point on the Linea termi-
nalis.
 Chapter 8 Bones, Part 2: The Appendicular Skeleton 195

TA B L E 8 . 2 Comparison of the Male and Female Pelves

Characteristic Female Male

General structure and Tilted forward; adapted for childbearing; true Tilted less far forward; adapted for support of a
functional modifications pelvis defines the birth canal; cavity of the true male’s heavier build and stronger muscles; cavity
pelvis is broad, shallow, and has a greater capacity of the true pelvis is narrow and deep
Bone thickness Less; bones lighter, thinner, and smoother Greater; bones heavier and thicker, and markings
are more prominent
Acetabula Smaller; farther apart Larger; closer
Pubic angle/arch Broader (80° to 90°); more rounded Angle is more acute (50° to 60°)

Anterior view

Pelvic brim

Pubic arch

Sacrum Wider; shorter; sacral curvature is accentuated Narrow; longer; sacral promontory more ventral
Coccyx More movable; straighter Less movable; curves ventrally
Greater sciatic notch Wide and shallow Narrow and deep

Left lateral view

Pelvic inlet (brim) Wider; oval from side to side Narrow; basically heart-shaped

Pelvic outlet Wider; ischial tuberosities shorter, farther apart, Narrower; ischial tuberosities longer,
and everted sharper, and point more medially

Posteroinferior view