Pelvis X-ray (1 to 2 views)

What it is

The pelvis is a ring: the sacrum at the back, the two large hip bones at the sides, and the sockets that the thigh bones sit in. Because it is a ring, a break in one place often means a second break somewhere else along it, and a single flat picture of the whole ring is the fastest way to see both. This code covers the short version of that study — one or two exposures, usually a straight-on view of the pelvis with the patient lying on their back, and sometimes a second angled view. The technologist positions the patient, steps behind a screen, and the exposure lasts a fraction of a second.

Why it is done

• To look for a fracture of the hip or the pelvic ring after a fall, a car crash, or any hard impact
• To check the joint surfaces where the thigh bones meet the pelvis, which is where hip arthritis shows up as narrowing and bone spurs
• To see the shape and alignment of the bones in someone with hip or groin pain that has not settled
• To look at hardware already in place, such as a hip replacement or a plate and screws, and see how it sits in the bone

What to expect

There is nothing to do beforehand beyond changing into a gown and taking off anything metal around the waist and hips — belts, zippers, and jewelry all show up on the image. The patient lies on the table, often with the feet turned slightly inward, and is asked to hold still and sometimes to hold a breath. The whole visit is usually a few minutes. Someone with a suspected hip fracture will be moved carefully and may have the film taken on a stretcher or in bed rather than on the x-ray table. A radiologist reads the images afterward and reports to the ordering clinician.

Questions worth asking

• Is this a pelvis series, a dedicated hip series, or both? A hip x-ray of one side is a separate exam from the pelvis view and can appear as a second line on the bill.
• If the pelvis film is unclear and a CT follows the same day, will I be billed for both studies?
• Was this taken in the emergency department or in an outpatient radiology suite? The same two images cost very differently in those two places.
• Is the radiologist who reads the film employed by the hospital or by an outside group, and is that group in my network?