The femur series for pediatrics is comprised of an anteroposterior (AP), and lateral radiograph. The series is utilized to assess for abnormalities pertaining to the shaft of the femur (often requested when fringe abnormality is seen on hip or knee radiographs). It is not an effective series to assess for a neck of femur fractures or injuries of the tibial-femoral joint.
On this page:
Indications
The femur radiographs are performed for a variety of indications including:
trauma with a suspected fracture
obvious deformities
suspected foreign body
inability to weight bear
osteomyelitis
Projections
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demonstrates the lower limb in a natural anatomical position
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orthogonal projection to the AP view
Gonadal shielding
The use of gonadal and fetal shielding has been deemed as non-beneficial to patients' health in current evidence 1-3 and may or may not be useful for pediatric extremity imaging. Placing gonadal shielding can increase the examination time and may cause the child more stress.
Tips for pediatric femur radiography
The major difficulty in pediatric femur radiography relates to:
To overcome this, a variety of techniques can be used 4:
distract the patient with toys, games and/or conversation
using the swaddling technique; wrap the child in a blanket to promote comfort and sleep
Immobilization techniques
Children will find it difficult to keep their legs still; particularly if the limb is injured. As the child will be supine, it is helpful to have the parent in the child's direct line of sight in order to keep the child calm.
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