Shenton's Line

Definition

Shenton's line (also called the Menard-Shenton line) is an imaginary smooth, continuous curved arc drawn on an AP (anteroposterior) pelvis X-ray. It runs along:

The superior/upper border of the obturator foramen, and continues
Along the inferior/medial border of the femoral neck

In a normal hip, these two structures form a smooth, unbroken arc. Any disruption of this curve indicates pathology.

S Das Manual on Clinical Surgery, p. 248
THIEME General Anatomy and Musculoskeletal System, p. 7073

Radiographic Image

The image below shows Shenton's line highlighted (yellow arcs) on both hips of a normal pelvis AP X-ray. Note the smooth continuous curve from the obturator foramen onto the femoral neck on each side:

Shenton's line on AP pelvis X-ray - yellow arcs mark the normal continuous curve on both hips

Campbell's Operative Orthopaedics 15th Ed - Figure 7.36

Clinical Significance - When is it disrupted?

A broken or disrupted Shenton's line indicates displacement of the femoral head relative to the acetabulum. Causes include:

Condition	Mechanism
Developmental Dysplasia of Hip (DDH)	Superior and lateral subluxation/dislocation of femoral head
Fractured neck of femur	Proximal femur displaces superiorly; arc is broken
Perthes' disease	Femoral head flattens/collapses, disrupting the arc
Pathological dislocation	Any cause of hip dislocation (septic arthritis, tuberculosis)
Hip subluxation	Partial displacement shifts the femoral neck inferiorly

"In Perthes' disease or in tuberculous arthritis where destruction of the head of the femur becomes obvious, this line will be slightly distorted; but in pathological dislocation this line will be grossly distorted." - S Das Manual on Clinical Surgery

Image: Disrupted Shenton's Line (Perthes' Disease)

The right hip shows disruption of the line - the solid arc on the left (normal) does not match up on the affected right side:

Shenton's line shown on normal left hip; disrupted on right hip affected by Perthes' disease

S Das Manual on Clinical Surgery, Fig. 15.44 - Shenton's line drawn on normal left side; disrupted on the right (Perthes' disease)

Use Alongside Other Lines

On a pediatric hip X-ray, Shenton's line is used in combination with:

Hilgenreiner line - horizontal line connecting both triradiate cartilages
Perkins-Ombredanne line - vertical line from the lateral acetabular rim, perpendicular to Hilgenreiner line
Acetabular index (Hilgenreiner) - normally ~35° at birth, <10° by age 15

In DDH: the Shenton line is discontinuous, the acetabular angle is increased, and the Perkins-Ombredanne line runs medial to the femoral shaft.

THIEME General Anatomy and Musculoskeletal System, p. 7079
Campbell's Operative Orthopaedics 15th Ed 2026, Fig. 7.36

Key Points for Exams

Normal = smooth continuous arc from obturator foramen to inferior femoral neck
Disruption = femoral head displacement (superior in fracture/dislocation; inferior less common)
Used on AP pelvis X-ray (not lateral)
Named after Edward Warren Shenton (British radiologist, early 20th century)
Also called Menard-Shenton line (Menard described it alongside Shenton in some literature)

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